• 한국노년학
• /
• 제31권3호
• /
• pp.673-689
• /
• 2011

본 연구는 농어촌 건강취약지역의 노인들이 경험하는 건강불평등 경험의 의미를 focus group으로 연구한 질적연구이다. 연구목적은 농어촌 건강취약지역의 노인건강불평등을 이해하고 건강증진을 위한 기초자료를 제공하고자 한다. 경상남도의 20개 시·군에서 2004년부터 2007년간 표준화 사망비가 지속적으로 높은 40개 취약지역으로 선정된 읍·면·동 중에서 15개 농어촌지역을 임의로 선정하여 각 지역별로 focus group 참여자를 구성하고 현상학적 분석방법에 근거하여 분석하였다. 연구결과로 농어촌 건강취역 지역 노인들이 경험하는 건강불평등은 생태학적 환경오염, 지역사회 서비스부족과 위해환경, 낮은 경제상태, 건강행태차원에서 건강관리 부족의 4개 범주로 나타났다. 이러한 결과를 바탕으로 건강취약지역의 노인건강 증진을 위한 몇 가지 제언을 제시하였다.

• 한국보건간호학회지
• /
• 제32권3호
• /
• pp.363-375
• /
• 2018

Purpose: The aim of this study was to identify the influence of children's and caregivers' perceptions of local neighborhood environments on children's physical activities (PAs) and screen-based activities (SBAs) among low-income families. Methods: Secondary data analysis was performed using the data of 171 low-income children attending community child care centers and of their caregivers. Descriptive analysis, factor analysis and logistic regression analysis were employed to analyze data. Results: PAs were insufficient and SBAs were excessive in the majority of children. Children and primary caregivers had moderately negative perceptions of their local neighborhood environments. However these perceptions were not found to affect children's PAs or SBAs significantly. Conclusion: Although perceptions of local neighborhoods were not found to significantly influence children's PAs or SBAs, efforts are needed to make community child care centers and neighborhoods safer and more activity-friendly.

• 보건행정학회지
• /
• 제18권4호
• /
• pp.66-84
• /
• 2008

Objectives: This study aimed to. offer some fundamental evidences for the stroke management policy by investigating the trends of medical care utilization and regionalization in stroke inpatients. Methods: We used the National Health Insurance claims and registry data for stroke inpatients from 1998 to 2005. Among all stroke inpatient claims data, self-employed insured and their dependents were only included in this study. The classification of stroke was based on ICD-10(I60-I69) and its subtype was divided by hemorrhage(I60-I62) and infarction(I63-I64) type. To evaluate regionalization of medical care utilization, relevance index was calculated by regions. The regions were classified 8 large catchment areas and 163 self authorized areas. Results: The overall medical care utilization rate of stroke inpatient has been increased, especially infarction subtype. Among medical care institutions, the utilization of hospital has been the most rapidly increased. Although considered annual rate of interest, total medical cost of stroke inpatients has been increased, Totally, more than 84% of stroke inpatient were admitted to medical care institutions in their own large catchment area during 1998-2005. The relevance indices in their own large catchment area (self sufficiency rates) were more than 70% in most areas regardless of stroke subtype except Chungbuk catchment area. Self sufficiency rates of stroke inpatients among 163 self authorized areas in 1998 and 2005 were 84.2% and 83.1% in metropolitan, 46.7% and 45.5% in urban, and 19.5% and 22.6% in rural areas, respectively. Conclusion: Stroke management policy for improvement of distribution at the district level, especially in rural areas, may be helpful for reducing regional inequality in stroke.

• 농촌의학ㆍ지역보건
• /
• 제9권1호
• /
• pp.27-38
• /
• 1984

The Family Planning Project as a birthcontrol policy has been enthusiastically carried out by the government since 1962. But gradually it get less enthusiastic. Therefore, it is required to establish a more comprehensive and systematic plan and to carry out it thoroughly. And it is needless to say that people's knowledge about family planning, their attitudes and their practice should be concretly comprehended. Taking these things into consideration, this study surveys the general situation on family planning among 237 married women of less than 34 years in Guro 6-dong, one of target areas for Korea University Health Project from Sep. 17, 1984 to Oct. 13, 1984. The results are as follows; 1) Most of the subjects (62.8%) want 2 children and 13.6% want one child. But son-preference consciousness is remarkably revealed among them, which is thought to cause social inequality between man and woman. Therefore, it needs to change the traditional son-preference convention, for equality of all men regardless of sex. 2) The rate of induced abortion experience by person is 61.6% and the average frequency is 1.4. Almost all the induced abortion are carried out at clinics and hospitals during 2~3 months after conception. To prevent these unnecessary conception and induced abortion in view of maternal health, ethics and economics, proper contraceptive measures should be emphasized. 3) Temporary contraceptives should be sold more widely in the basis of free trade in order to practice the intensive and comprehensive family planning because the degree which Health Center has been utilized for buying temporary contraceptives is low. 4) There are serious problems such as the side effects and the lack of follow up care in permanent contraceptives. Those lower the practice rate of permanent contraception. Therefore it is necessary to improve the quality of permanent contraception practice and strengthen the follow-up care.

• 한국치위생학회지
• /
• 제18권6호
• /
• pp.911-920
• /
• 2018

Objectives: This study investigated the relationship between demographic and socioeconomic characteristics of the Korean elderly and their unmet dental care needs, by using the 2015 data from the $6^{th}$ Korea National Health and Nutrition Examination Survey (NHANES). Methods: In total, 1,372 elderly persons aged 65 and over, who responded to the $6^{th}$ NHANES, were included in the final analysis. Logistic regression analysis was performed in order to identify any relationship between demographic and socioeconomic characteristics and unmet dental care needs. Results: The rate of unmet dental care needs was shown to be less by 0.799 times in the elderly who reside in dong than those who live in eup and myeon (OR: 0.799, 95% CI: 0.679-0.959). Unmet dental care needs were higher in participants with 'low' and 'below average' than 'above average' income, by 1.645 times (OR: 1.645, 95% CI: 1.087-2.366) and 1.172 times (OR: 1.172, 95% CI: 1.108-1.880), respectively. Elderly individuals living alone had a higher rate of unmet dental care needs than those living with their family by 1.157 times (OR: 1.157, 95% CI: 1.084-1.498). Conclusions: Demographic and socioeconomic factors influenced unmet dental care needs, causing inequality. Proper policy support to the vulnerable should be considered in order to enhance the elderly's access to dental care.

• 한국임상약학회지
• /
• 제32권4호
• /
• pp.288-302
• /
• 2022

Objective: Community pharmacists are frontline health care providers, but have been considered as underutilized professionals on a daily basis. The purpose of this scoping review was to identify information about the impact of the COVID-19 pandemic on community pharmacy services and to evaluate new services that could be applicable. Methods: We searched MEDLINE and EMBASE for studies published up to January 10, 2020. Search terms consisted of keywords relevant to this review, including "COVID-19", "community pharmacy", and "community pharmacist". This review targeted studies of pharmacist services provided by community pharmacies in OECD member countries during the COVID-19 pandemic period. Results: Twenty-seven studies were included in this review. Changes in community pharmacist services due to the COVID-19 pandemic were broadly classified into four categories. First, as the face-to-face services became challenging, various non-face-to-face services were being tried. Second, community pharmacists directly participated in the services to prevent the spread of COVID-19. Third, community pharmacists made efforts to support continuity of care for patients who experienced difficulties due to the reduced professional care as health and medical resources are concentrated in response to COVID-19. Fourth, community pharmacist services were emerging, targeting patients suffering from greater health inequality during the pandemic. Patients expressed high demand and satisfaction for the service of the community pharmacist, and pharmacists reported self-efficacy and professional pride. Conclusion: This study demonstrated that in the era of the COVID-19 pandemic, various community pharmacist services have been tried and received positive evaluations from patients in several OECD countries.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권sup3호
• /
• pp.201-204
• /
• 2016

This study aimed to quantify associations of the human development inequality (HDI) index with incidence, mortality, and mortality to incidence ratios for eight common cancers among different countries. In this ecological study, data about incidence and mortality rates of cancers was obtained from the Global Cancer Project for 169 countries. HDI indices for the same countries was obtained from the United Nations Development Program (UNDP) database. The concentration index was defined as the covariance between cumulative percentage of cancer indicators (incidence, mortality and mortality to incidence ratio) and the cumulative percentage of economic indicators (country economic rank). Results indicated that incidences of cancers of liver, cervix and esophagus were mainly concentrated in countries with a low HDI index while cancers of lung, breast, colorectum, prostate and stomach were concentrated mainly in countries with a high HDI index. The same pattern was observed for mortality from cancer except for prostate cancer that was more concentrated in countries with a low HDI index. Higher MIRs for all cancers were more concentrated in countries with a low HDI index. It was concluded that patterns of cancer occurrence correlate with care disparities at the country level.

• 한국콘텐츠학회논문지
• /
• 제17권11호
• /
• pp.435-445
• /
• 2017

본 연구는 단순 의료이용의 차이를 확인하거나 제한적인 의료필요와 의료이용지표를 활용하여 의료이용의 형평성을 연구한 선행연구의 한계를 극복하기 위하여 수행되었다. 구체적으로 의료필요지표로 활동제한여부, 만성질환이환여부와 수, 주관적 건강상태를 활용하였고 의료이용지표로 외래와 입원, 응급이용횟수와 진료비를 활용하였다. 아울러 의료필요를 고려한 의료이용의 형평성을 분석하기 위하여 집중지수와 집중곡선, Le Grand계수를 활용하였다. 주요 분석결과, 첫째 단순한 의료이용 집중정도로 볼 때 저소득층의 의료이용량이 고소득층에 비해서 많은 것이다. 특히, 저소득층 입원이용이 외래나 응급이용에 비해서 크게 많았다. 둘째, 저소득층에게 의료필요가 집중된 것으로 나타났다. 즉, 저소득층의 건강상태가 좋지 않은 것이다. 셋째, 의료필요를 고려한 의료이용의 형평성을 확인하기 위하여 Le Grand계수를 산출하였다. 의료필요를 고려하더라도 고소득층의 의료이용량이 많았다. 즉, 단순한 양적인 의료이용은 저소득층의 이용이 많았지만, 의료필요를 고려한 의료이용횟수는 고소득층이 많은 것이다. 또한, 전체진료비는 활동제한여부와 만성질환수를 고려했을 때는 고소득층의 의료이용이 많았으며 주관적 건강상태와 만성질환이환여부를 고려하였을 때는 저소득층의 의료이용이 많았다. 따라서 대체로 저소득층이 건강상태에 비해 의료이용을 충분히 하지 못하는 것을 알 수 있었다. 한편, 저소득층의 주관적 건강상태와 만성질환이환여부 관련 의료필요에 비해 의료비지출이 많았는데 이는 저소득층이 스스로의 건강상태와 만성질환이환에 대한 인식을 소극적으로 함으로써 의료필요가 과소평가된 것이 원인으로 사료된다.

• 디지털융복합연구
• /
• 제13권8호
• /
• pp.483-493
• /
• 2015

농어촌 지역은 산업화 도시화로 도시보다 건강관리가 미흡하며 이에 따른 지역 간 건강불균형 문제가 중요한 사회적 아젠다가 되었다. 이 연구는 사회적 자본과 건강정보, 의료 커뮤니케이션 요인들이 지역사회의 건강상태에 어떠한 영향을 미치는지를 구조방정식 모델을 통해서 검증하고자 하였다. 먼저 사회적 자본은 의료진과의 의사소통성에 영향을 미치는 것으로 나타났고, 의료진과의 의사소통성은 건강상태에 영향을 미치는 것으로 나타났다. 또한 건강정보추구는 건강행위, 인터넷 건강정보이용에 영향을 미치는 것으로 확인되었으며, 인터넷 건강정보이용을 매개로 건강상태에 영향을 미치는 것으로 나타났다. 마지막으로 인터넷 건강정보이용과 건강행위는 건강상태에 영향을 미치는 것으로 확인되었다. 이 연구는 사회적 요인과 커뮤니케이션 요인이 농어촌 건강상태에 영향을 미치는 선행 경로구조를 형성하고 있다는 점을 검증함으로써 지역사회 건강상태의 결정요인에 대한 설명력을 한층 풍부하게 하는 데 기여하고 있다.

• 한국치위생학회지
• /
• 제20권2호
• /
• pp.129-137
• /
• 2020

Objectives: Using the annual data from the 2016 Korean Health Panel, this study aims to identify the factors that affect the dental utilization and expenditure of patients with chronic diseases, and to provide basic data to explain the inequality gap in dental utilization. Methods: The dental utilization and expenditure of 3,557 patients with chronic diseases were analyzedfor frequency using the SPSS Windows version 23.0 (SPSS Inc. IL, USA). Analysis of the factors that affect dental utilization and expenditure were performed using a multiple regression analysis. The level of statistical significance was 0.05. Results: The frequency of dental utilization in patients with chronic diseases was high for subjects who were younger than 65 years and those whose education level was below high school. The frequency of dental utilization was relatively lower for subjects who did not have disabilities and those with healthier subjective health status. The dental expenditure of patients with chronic diseases was higher in subjects who were younger than 65 years and those with greater household income. Conclusions: The above findings suggest that a plan is needed to control dental utilization by efficiently managing chronic diseases, and that a policy-based plan is needed to devise ways to supplement the uninsured medical expenses of dental care.