• Title/Summary/Keyword: Health Care Equity

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A Regionalization Model to Increase Equity of Access to Maternal and Neonatal Care Services in Iran

  • Daniali, Zahra Mohammadi;Sepehri, Mohammad Mehdi;Sobhani, Farzad Movahedi;Heidarzadeh, Mohammad
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.1
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    • pp.49-59
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    • 2022
  • Objectives: Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. Methods: First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. Results: It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. Conclusions: This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.

A Study on Physical Infrastructure and Indicator Development for the Realization of Community Care (지역사회 통합돌봄의 실현을 위한 물리적 인프라 및 지표개발 연구)

  • Kim, Hyunju;Lee, Seungji
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.26 no.4
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    • pp.29-38
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    • 2020
  • Purpose: The first thing to be done in promoting community care is local diagnosis. Therefore, this study attempted to derive the physical infrastructure to be diagnosed, and to develop diagnostic items and diagnostic indicators applicable to this. Methods:: First, the physical infrastructure related to the community care is derived. And the diagnosis items are derived using the checklist of 'community support and health services' in the WHO Guide for Global age-friendly cities. Next, by analyzing previous studies, we develop diagnostic indicators for each diagnostic item and explore their applicability. Results: As a result of deriving the physical infrastructure for each area of housing, health service, and nursing care for community care, 22 facilities were derived for 9 types. Diagnosis items for the facilities are 1)regional equity, 2)proximity between facilities, 3)transportation access, 4)regional use, 5)barrier-free design, 6)diversity of facilities, and a total of 14 diagnostic indicators was derived. We reviewed and suggested the applicability of diagnostic items and indicators by each physical infrastructure. Implications: For the realization of community care, local diagnosis should not be limited to sim- ply grasping the presence or absence of facilities and the total amount. Instead it should strengthen capabilities by conducting diagnosis to understand the performance of facilities.

A Study on the Curriculum of Global Health Education (글로벌 건강교육 교과과정에 관한 연구)

  • Choi, Kyung Sook;Kim, Hack Sun;Lee, So Young;Dressel, Anne;Galvao, Loren W.;Jun, Myunghee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.22 no.2
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    • pp.220-227
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    • 2016
  • Purpose: This study aimed to understand current global health education and suggest its future direction for Korean undergraduate nursing students. Methods: After reviewing literature to identify key concepts applicable to global health nursing curricula, the authors analyzed global health curricula from 98 nursing colleges by using a framework that was developed for this study. Results: Among the 201 nursing colleges, 98 (48.8%) schools offered one or more global health-related courses. The titles of these courses were divided into two categories: Multiculturalism and international nursing. Multicultural courses were offered mainly for freshmen (40.5%) or sophomore students (40.5%), whereas international nursing courses were offered mainly for senior students (35.9%). These courses trained nursing students to be culturally competent in providing nursing care for immigrants or foreign travelers living in South Korea. Conclusions: It is evident that interest in global health education is growing in South Korea. However, the scope and content of global health education needs to be broadened beyond multiculturalism and international nursing so that it can prepare nursing students to promote global health equity, reduce global health disparities, and work competently with globally-focused organizations.

Analysis of trends in the dental care quality improvement contests (치과 의료의 질 향상(Quality improvement) 경진대회 경향 분석)

  • Hwang, Soo-Jeong;Shin, Hosung;Kim, Jin;Kim, Myoung-Hee;Ahn, Eunsuk
    • Journal of Korean Academy of Dental Administration
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    • v.9 no.1
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    • pp.38-43
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    • 2021
  • Based on data from the Korean Academy for Dental Administration, which has been conducting the Dental Quality Improvement (QI) Contest since 2010, we aimed to provide basic data for the development of dental quality improvement indicators by analyzing the trends of dental quality improvement activities. A total of 54 articles in the dental QI contest from 2015 to 2021 were used to search for frequently used words and to classify the quality of dental care. The criteria for the quality dimension of dental care were first classified into structure, process, and outcome, and secondary classification was performed into patient safety, timeliness, patient-centeredness, equity, efficiency, effectiveness, and accessibility. The frequently used key terms were satisfaction (five times), efficiency (four times), system (three times), and implant (three times). The activities for process evaluation were high at 62.26%, structural evaluation activities at 35.85%, and outcome evaluation activities at 1.89%. According to the components of dental care quality improvement, the activity performed under efficiency was the highest (33.96%), followed by patient-centeredness (18.87%), effectiveness (16.98%), patient safety (15.09%), accessibility (5.66%), timeliness (1.89%), and the equity (1.89%). QI activities in dental hospitals were mainly activities on improvement in structure and process, as well as activities on efficiency, patient-centeredness, effectiveness, and patient safety.

Use of Integrative Medicine among primary care patients in Western counties - Its implication for traditional Korean medicine in primary care system - (선진국의 일차의료부문의 통합의료 - 일차보건의료체계에서의 한의학에 주는 함의 -)

  • Han, Dong-Woon
    • Journal of Society of Preventive Korean Medicine
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    • v.16 no.1
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    • pp.1-13
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    • 2012
  • The objective of this study is to discuss the role of integrative medicine (IM) in contemporary health care settings, and how and which factors affect and facilitate the success of IM in terms of the integration of complementary and alternative medicine (CAM) and conventional medicine in primary health care (PHC). IM is meant to provide the best possible health care, for both patient and physician. The way of IM use in the developed countries presents various ways that IM can be provided, and it appears that strategies have been successfully developed to facilitate integration. Although few of the barriers to the integration of CAM and conventional medicine have been resolved, concerns over the legitimacy of CAM in health care (e.g., safety, biomedical evidence, and efficacy) are being overcome by the use of evidence-based practice in IM delivery. There are dominant models of IM that have been developed. The model types signify different levels of equity between CAM and conventional medicine in regard to the power, autonomy, and control held by each. However, the factors common to all IM models, whether describing CAM as supplementary or complementary to conventional medicine, is the concept of a health care model that aspires to be client-centred and holistic, with focus on health rather than disease as well as mutual respect among peer practitioners. Finally, this study concluded that the growth and viability of traditional Korean medicine(TKM) depend on evidence-based practices and identifying the successful influences on the integration of TKM and conventional medicine for recognition of its inherent value in PHC. Some recommendations for the integration of TKM and conventional medicine were suggested.

A Study on the Accessibity of Physical Therapy Service in Public Health Center (보건소의 물리치료서비스 접근성에 관한 연구)

  • Yoon, Hee-Jong;Yoon, Na-Mi
    • Journal of Korean Physical Therapy Science
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    • v.3 no.4
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    • pp.159-169
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    • 1996
  • Every citizen has a right to get the least health care service for their living and should be guaranteed the right of health which is specified in the constitution of Korea. Therefore, health care service should realize the equity and accessibility of service by the equitable distribution which is needed for health care. The objects of this study were the patients who was treated by the physical therapy in health care center(two of them located in cities and others are in agricultural areas). These are the results of our study. First, the age, job, sex and experience of former treatment of objects showed no meaningful statistic difference in the part of convenience of health care center, where as the system of health scurity showed highly meaningful difference. Second, The age, job and system of health care of objects showed no meaningful difference in the part of attitude and appreciation to therapist, where as the experience of former treatment in other center showed highly meaningful difference. Third, The age, job and sex of objects showed no meaningful difference in the part of the appreciation to results of service, where as the system of health scurity and the experience of former treatment in other center showed meaningful difference. To offer the effective physical therapy, the government of province or nation should invest the large amount of financial fund continuously and make the plan of efficient operating system for the physical therapy service room of public health center which is the most nearly located to native citizen. The problem of distance, low reliability to public service, public relation and reliabity should be improved to raise the utility of physical therapy room. And also, the physical therapy room should be opened in health subcenter to offer the condition of the native citizen's healthy life.

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Oral healthcare quality and measurement of quality indicators (치과의료의 질과 질지표 측정)

  • Shin, Hosung
    • Journal of Korean Academy of Dental Administration
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    • v.8 no.1
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    • pp.8-14
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    • 2020
  • To provide high-quality oral health services, the concept of measurable oral health quality must first be defined. Owing to reports of significant preventable adverse events in the healthcare service provision process, the recognition and consensus of patient safety and patient-centered health service provision was formed. Six areas that are important medical care have been identified, including the quality along with existing concepts such as timeliness, effectiveness, equity, and efficiency of medical services. While there is ongoing research on the quality of oral health, there is not yet any internationally accepted definition. The purpose of this study is to introduce the ideas of oral healthcare quality and quality indicators that have been developed and announced in the field of dentistry.

Variations and Factors Associated with the Supply and Utilization of Nursing Home Services in Japan and South Korea (한국과 일본 장기요양시설 공급과 이용의 지역 간 변이)

  • Kim, Hongsoo;Yoon, Nan-He;Lee, Seyune;Hashimoto, Hideki
    • Health Policy and Management
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    • v.30 no.1
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    • pp.100-111
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    • 2020
  • Background: Few studies have examined the performance of the public long-term care insurance (LTCI) from the perspective of geographic equity. This study investigated regional variations and associated factors in the supply and utilization of nursing home care within and also between Japan and Korea. Methods: A comparative dataset was developed by extracting data from 2013-2015 LTCI statistics yearbooks and Organization for Economic Cooperation and Development regional statistics, as well as other comparable data in Japan and Korea. The unit of analysis was the prefecture in Japan and the province in Korea. We computed variation indices and conducted regression analyses for regional variations within each country and decomposition analyses to examine the variations between the countries. Results: The overall regional supply and use of nursing home care were higher in Japan, but the regional variations in Korea were larger than in Japan. In both countries, the nursing home supply was negatively associated with the proportion of older people with independent living. Nursing home use was also negatively associated with the supply of hospital beds and home care agencies in Korea; the relationship was the opposite in Japan, however. The country-based differences were more likely to be explained by differences in the distributions of the variables included in the analytical model than country-specific characteristics. Conclusion: Regional-level nursing home supply and use were unequal in both countries, and the contributing factors were not the same. Policy efforts are needed to advance regional equality in long-term care (LTC) and collaboration between health and LTC institutions for frail older people, especially in Korea.

Public Policy for Hospitals in the United States (미국의 병원정책)

  • Kwon, Soon-Man
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.238-260
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    • 1998
  • This article describes the theoretical foundations of government policy for hospitals in terms of correcting market failure and enhancing equity. It then discusses the characteristics that desirable payment systems should have, and the effects of the DRG-based prospective payment system on hospital behavior, its financial performance, hospital industry, and health care expenditure. The rationales and impacts of other public policies for hospitals such as antitrust and fair trade regulation, dissemination of practice guidelines and hospital mortality information, regulation of hospital capital investment, and tax policy are also discussed.

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Socioeconomic Determinants of Korean Medicine Ambulatory Services: Comparing Panel Fixed Effect Model with Pooled Ordinary Least Square (한방외래의료 이용의 사회경제적 결정요인 연구: 의료패널자료를 이용한 고정효과모형과 합동 Ordinary Least Square 모형의 비교)

  • Park, Min Jung;Kwon, Soon Man
    • Health Policy and Management
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    • v.24 no.1
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    • pp.47-55
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    • 2014
  • Background: Korea is considered to have an integrative health system where both western medicine and Korean (traditional) medicine are officially recognized and provided. Although Korean medicine has been covered by National Health Insurance over 20 years, equity in the utilization of Korean medical care has rarely been examined. Methods: We examined medical care utilization and expenditure of outpatient Korean medicine using panel fixed effects model to remove selection bias. Then we compared it with pooled ordinary least square (OLS) model. This study used Korea Health Panel data, which provides accurate information on out-of-pocket health care payment, including non-covered medical services. Results: Principal findings indicate that the frequency of the utilization of Korean medicine is related with unobservable individual choices different from western medicine, so the panel fixed effect model is appropriate. But pooled OLS model is better fitted for the expenditure of Korean medicine, after controlling for western medical care expenditure. After adjusting for the selection bias, socioeconomic status (income, education) was significantly associated with the expenditure of Korean medicine, but not with the frequency of the utilization of Korean medicine. Conclusion: This study shows that expenditure of Korean medicine utilization is inequitable across socioeconomic groups, which implies that health insurance coverage of Korean medicine is not sufficient.