• Title/Summary/Keyword: Health care delivery system

검색결과 312건 처리시간 0.021초

지방의회의원들의 보건정책에 대한 인식 (The Local Council Members' Attitudes to the Health Policy)

  • 김병익;배상수;조형원
    • 보건행정학회지
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    • 제9권2호
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    • pp.55-76
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    • 1999
  • In order to understand the local council members' attitudes to the health policy, we conducted mail surveys using self-administered questionaire for 2 months(February and March. 1995). The study subjects were 2.312 local council members in Korea, but only about 11% among whom. 257 persons, responded to 2 times mail survey. This response rate revealed that the local council members was not interested in health care fields. The main results were as follows; The respondents thought that the economic and income development was most important among 15 regional policy agendas and the health care was the 5th or 7th important agenda. They. who had more health needs of and poor access to health care, tended to think that the health care was more important. They considered lobbying to and persuading the civil servants as the best method to tackle the local health care policy agenda. The respondents, who had poor access to health care facilities. tended to set the highest priority for the expansion of public and private health care resources. They expected that the election of local governor would activate the public health program more than thought that the program was implemented more actively than other region. The main opinion of respondents was that the central government had to take over planning and financing for the public health program, and the basic local government had to implment the program and budgeting. The majority of respondents agreed the private dominant medical care delivery system and nation-wide uniformed financing mechanism. Over 60% of them suggested that they were ready to suffer environmental pollution inducing health hazards for the purpose of regional economic and income development. About 75% of them favour the campaign for antismoking regardless of reducing local government's revenue from sale tax.

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한방의료 이용실태에 관한 조사 연구 - 전국 한의원 이용자를 중심으로 - (A Study on Utilization Patterns of Oriental Medical Care)

  • 이규식;조경숙
    • 보건행정학회지
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    • 제9권4호
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    • pp.120-139
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    • 1999
  • The objectives of this study were to examine the utilization patterns of oriental medical care and to discover problems in its delivery. The data for this study were collected from a questionnaire survey mailed out from March 10 to April 9 1999 to 6.346 oriental medical clinic. The questionnaires were then distributed to two patients in each clinics. Of these questionnaires. 670 were completed and returned. The major statistical methods used for the analysis were the t-test. ANOVA, and x$^2$-test. The major findings are as follows: 1. Respondents reported visiting oriental doctors twice as often as they visited western doctors(All those completing the survey received the questionnaire at oriental medical clinics). 2. The number of reported visits to oriental physicians according to among gender, age, marital status, education, income and residence. Males, married respondents, the elderly and the residents of rural areas visited oriental physicians more frequently than females, singles, younger respondents and urbanites. Those people belonging to the middle income class and middle education level also more frequently visited oriental physicians. 3. There are several factors that restrict the utilization of oriental medical care, such as the limitation of the scientific diagnostic instrument use commonplace reliance upon western medical techniques, and the perception of high price for oriental medical care. It is very important to focus oriental medical care onto the fields of acupuncture, circulatory system disease, musculoskeletal system ailments, etc. to improve the utilization of oriental medical care. Other policies for the improvement of oriental medical care include the standardization of price, quality and quantity of oriental medicine.

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보건의료제도 변화에 대한 지역주민의 수용태도 분석 (A Study of Attitudes to Changed Health Care Delivery System in a Community)

  • 유승흠;손명세;박종연
    • Journal of Preventive Medicine and Public Health
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    • 제22권1호
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    • pp.162-168
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    • 1989
  • This study was conducted to analyse attitudes to a new health care system in a rural community. The specific purpose of this thesis was to classify attitudes to the patient referral system in Kangwha county, and to identify factors affecting the attitudes. Sampling was done by a multi-stage stratified cluster sampling method from the population. The data were collected in Kangwha county through a structured interview survey for two weeks in June, 1957. Attitudes to the patient referral system were classified into four types based upon answers to questions about awareness of the system, the recognition for the necessity of the system, and opinions on the improvement of the system. The four types of attitudes were active acceptance(10.2%), partial acceptance (27.2%), refusal(35.8%), and indifference(26.7%). The respondent's age, educational level, age of head of household, medical insurance fee, the number of ill family members, and the percentage of medical utilization by the family were the variables which affected the attitudes. The medical insurance fee, respondent's age, age of head of household, and the percentage of medical utilization by the family were the statistically significant discriminant factors of the four types of attitudes.

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지역사회 간호 서비스 전달 체계 모형 개발 -가정방문서비스를 중심으로- (Development of Community Health Nursing Service Model: - Based on the Visiting Nurses Project in Seoul, Kyonggi, and Kang-won Area-)

  • 김성실
    • 지역사회간호학회지
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    • 제12권2호
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    • pp.361-374
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    • 2001
  • This study was done to identify a status of home visiting project as a community health nursing system, that was the organization. personal who have age, educational background, marital status, position, experience of the home visiting in the public sectors in part of Seoul. Kyonggi, Kang-won area, It was done to provide basis data for the development of effective visiting nurses project in the health sectors, where was Health Centers in urban and rural. Branch of Health Center in rural and Health posts. The question airs were distributed 352 public health workers who working place was 118 health workers in 12 health centers in Seoul. 56 public health workers among 39 health center and other public health sectors in Kyonggi and 178 public health workers among health center and health care sectors. Data collected from October to December. 2000. The analysis by SAS system with F test, percentage and frequency. The major result were as follows. The general characteristics of the respondent show that most of them were graduates from community college and RN-BS with broadcast that they had not completed CPHN course but only two health workers have trained for the visiting nurses project. As for their grade in the position, the most of health workers have seventh level and the other CHP were above sixth level in the health care post that in the government structure. This indicates that workers do not have great authority in decision making, the most period of works in the position was one and two years indicating that they change jobs frequently. On an average their clinical experience was 4.11 years which is ideal for the total service. As for preparation of staff for home visiting workers education on visiting nurses program have to receive short term or longer term training course for strong emphasis. The analysis showed that public health visiting workers responds about active job performance that based on an area, approach of acting by districts, education and position are shown statistically significant difference between acceptance of the visiting nursing job show the same as well as visiting nurses project. Special concerns for visiting Nursing care spread came to burden, many of activity carry out main solution is covered the health problem connective support system needs of quality and quantity which out health problem. As 71.1% of visiting health service held on the poor population was under the guardianship of the law, but people who health insurance wide application under law shown a tendency to increase gradually. The general characteristics of the patients showed 56.2% of female on average of age was 66.1 years old, they have health problem was the most of 47.6% of high blood pressure and stroke, the other and as a problem that economics, which is complex welfare with out health problem. Community health care service should be combined health and social work program. The form of delivery of visiting health care given the most guide and education with counselling and support. (33.6%) Among the six category of visiting care service shown statistically significant difference and next is fundamental care, remedy care with priority.

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반월(半月), 구로(九老), 여주(驪州) 지역주민(地域住民)의 보건의료행태(保健醫療行態)에 관한 기초연구(基礎硏究)

  • 조병희;차철환;염용태
    • 농촌의학ㆍ지역보건
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    • 제6권1호
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    • pp.44-60
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    • 1981
  • In Korea, the position of health among the sectors of everyday life lies behind the others. The inhabitants don't consider health so important and immediate as food and shelter. Primarily, it seemed more important for them to eat something and to educate their children than to secure health. Under this situations we must take into consideration their health status and health problems in terms of the social system. Health cannot be maintaned by itself. It inter acts with a set of social conditions such as income, knowledge about health, health institution, health insurance, social class, culture and etc. But the community health projects which have carried out in Korea since the beginning of 1970s focused mainly on the medical care and medical delivery itself regardless the background of health care. According to the existing results of socio-epidemiological and medico-sociological researches, a set of social conditions has a great effect on the inhabitants' health status and health care. So, such conditions will be considered primarily in Korea University Health Project. This paper is prepared as a preliminary step for such a program. In this paper we mainly inquired into the relationship between health and the attitudes of inhabitants.

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미국 전문간호사(NP)의 역할과 교육과정에 관한 고찰 (Nurse Practitioner Roles and Curriculums in the United States)

  • 이선옥
    • 한국간호교육학회지
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    • 제5권1호
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    • pp.97-105
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    • 1999
  • Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

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A Study on the Development of a Model for Providing Traditional Korean Medicine and Welfare Services for Community Care

  • Lee, Eun-Jin;Lee, Hee-Jung;Oh, Danny;Park, Jung-Youn;Kim, Dongsu;Lee, Sang-Nam;Lee, Gihyun;Lee, Ji-Yeon;Kim, Kyeong Han;Sung, Soo-Hyun
    • 대한약침학회지
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    • 제25권1호
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    • pp.15-23
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    • 2022
  • Objectives: This study aims to develop a community care model in traditional Korean medicine (TKM) by developing a community care participation model for the health of the elderly and deriving tasks to implement it. Methods: This study implemented a group interview with experts. A fact-finding survey was conducted targeting 16 local governments that are implementing a leading project to identify the status of TKM service provision and welfare service linkage in all regions. An expert group interview (FGI) targeted public and private sector experts for each job role, the former represented by those in charge of the central government's health care policy and administrative delivery system, and the latter by professors majoring in social welfare, professors majoring in health, and local TKM societies. After forming the expert groups, three expert group interviews were conducted. Results: Through collective interviews with experts, a model for providing TKM and welfare services in community integrated care was derived by dividing it into local and central government levels. The strategies and tasks for promoting TKM-oriented health welfare services were derived from 3 strategies, 8 tasks, and 20 detailed tasks. Conclusion: The core direction of the TKM health care model is the region-centered provision of TKM and welfare services. To this end, policy support for the use and linkage of health care service resources is required at the central government level, and linkage and provision of health welfare services centered on TKM are necessary through linkage and convergence between service subjects and between government health care projects.

장기요양 서비스를 누가, 얼마나, 얼마에 원하고 있는가? - 장기요양 서비스의 욕구와 결정요인 및 지불의사금액 - (The Want, its Determinants and the Willingness to Pay of the Long Term Care Service)

  • 김현철;홍나래;연병길;박태규;정우진;정진욱
    • 보건행정학회지
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    • 제15권4호
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    • pp.136-160
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    • 2005
  • Before introducing the national long-term care insurance in 2008, the want for long term care service has to be estimated and analysed. This study estimates the demand and analyses what determines the want of long term care service. This study investigated data of 3f6 elderlies, that was collected by age stratified random sampling. The elderies resided in Onyang 4 - dong (urban area) and Dogo-myun (rural area) In the city of Asan. The researchers visited the elderlies and their care giver, and assessed their demand for the long term care service and examined physical, mental, socio-economic status by the assessment tools for Korean Long-Term Care System. $64\%$ of the those who are entitled to be served refuse the long term care service. $26.7\%$ of them wants for home care service and $7.9\%$ want facility care service. It is estimated that the want of home care service are three or four times as much as that of facility care service. The demand for long term care service is 5.155 times higher for those who live in rural area (p=0.000), 3.040 times higher for those who do not have spouse(p=0.057), and 3.356 times higher for the people who is in medicaid than medical insurance(p=0.029). However, income(p=0.782), means(p=0.614), living alone(p=0.223), number of family to live with (p=0.341) and age of the elderly(p=0.420) are not related with the demand of long term care service. The assessment tools for Korean Long-Term Care System for need evaluation of the long term care service can reflect the demand well.(p=0.024) If medical care will cover $80\%$ of total cost, the willingness to pay of the out of pocket money of the people with medical insurance is 67,400 Korean Won(66.77 US$) for the home care service and 182,500 Korean Won(180.78 US$) for the facility care service. There is possibility that long term care demand is still small after Introducing the long term care Insurance due to the care given by family members. When developing service delivery system of long term care insurance, rural area has to be given more consideration than urban area because of the higher demand. The people who do not have spouse or are in medicaid have to be given special consideration as well.

한국의 의료기관 외래진료 민감질환 입원율: 의료이용 효율성 지표로의 활용 가능성? (Hospital Admission Rates for Ambulatory Care Sensitive Conditions in South Korea: Could It Be Used as an Indicator for Measuring Efficiency of Healthcare Utilization?)

  • 정건작;김진경;강혜영;신의철
    • 보건행정학회지
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    • 제26권1호
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    • pp.4-11
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    • 2016
  • Background: Hospital admissions for ambulatory care sensitive conditions (ACSCs), which are widely used as an indicator of poor access to primary care, can be used as an efficiency indicator of healthcare use in countries providing good access to health care. Korea, which has a national health insurance (NHI) system and a good supply of health care resources, is one such country. To quantify admission rates of ACSC and identify characteristics influencing variation in Korean health care institutions. Methods: By using NHI claims data, we computed the mean ACSC admission rate for all institutions with ACSC admissions. Results: The average ACSC admission rate for 4,461 institutions was 1.45%. Hospitals and clinics with inpatient beds showed larger variations in the ACSC admission rate (0%-87.9% and 0%-99.6%, respectively) and a higher coefficient of variation (7.96 and 2.29) than general/tertiary care hospitals (0%-19.1%, 0.85). The regression analysis results indicate that the ACSC admission rate was significantly higher for hospitals than for clinics (${\beta}=0.986$, p<0.05), and for private corporate institutions than public institutions (${\beta}=0.271$, p<0.05). Conclusion: Substantial variations in ACSC admission rates could suggest the potential problem of inefficient use of healthcare resources. Since hospitals and private corporate institutions tend to increase ACSC admission rates, future health policy should focus on these types of institutions.