Providing free primary care to everyone is an important goal pursued by many countries under universal health care programs. Countries like India need to efficiently utilize their limited capacities towards this purpose. Unfortunately, due to a variety of reasons, patients incur substantial travel and out-of-pocket expenses for getting primary care from publicly-funded facilities. We propose a set-covering optimization model to assist health policy-makers in managing existing capacity in a better way. Decision-making should consider upgrading centers with better potential to reduce patient expenses and reallocating capacities from less preferred facilities. A multinomial logit choice model is used to predict the preferences. In this article, a brief background and literature survey along with the mixed integer linear programming (MILP) optimization model are presented. The working of the model is illustrated with the help of numerical experiments.
본 연구는 성건강 간호 장애의 개념을 정립하고 정의하기 위해 시행되었다. 연구방법은 혼종모형을 이용하였으며, 자료수집은 4명의 대상자와 성건강 간호 장애와 관련된 문헌으로부터 수집하였다. 연구결과로 성건강 간호 장애는 5개의 차원과 6개의 속성으로 도출되었다. 성건강 간호 장애의 정의는 성건강 간호요구와 필요성에 대한 인식을 하고 있으나, 성과 관련한 접근의 어려움, 편견, 고정관념, 의사소통의 어려움과 성관련 지식 부족으로 대상자들에게 전문적인 성건강 교육 및 서비스를 제공하지 못하는 것으로 도출되었다. 본 연구는 간호사들이 경험하는 성건강 간호 장애를 줄이기 위한 전략수립을 위하여 성건강 간호장애를 평가하는 기초자료를 제공하였다는데 의의가 있으며, 성건강 간호를 제공하기 위해서 간호사들이 경험하는 성건강 간호 장애를 줄이기 위한 선행 과제로 성건강 간호 장애를 평가하기 위한 기초자료를 제공했다는데 의의가 있으며 본 연구를 기초로 하여 성건강 간호 장애를 줄이기 위한 프로그램 개발을 제안한다.
This study was conducted to describe trends of health services research (HSR) in Korea since 1968 and analyse the relevance of HSR to changes in health policy. Research methods are as follows: firstly, HSR articles were selected from 4 HSR related journals implicitly. Secondly, classification system of HSR was developed and then applied to previously selected papers in order to describe research trends. Finally, the frequency rankings of articles in research areas were compared with rankings in order of the importance of research area rated by experts. As a resesult, HSR articles have increased with time and three main research areas are health programme, health care financing, and health care organization/management. And many articles have been related to the efficiency and quality of health care since 1990. It seems HSR articles had little relevance to changes in health policy and policy environment. Especially, the recently disputed policy topic, namely the separation of prescription from disposing, has not received little attention since 1990. These findings suggest there is an urgent need for the reflection on HSR direction in Korea.
A purpose of this study is to understand Platonic View of Health in $\boxDr$Politeia$\boxUl$. Though Plato was not so much a doctor as a philosopher. he had health care of children at heart. He mapped out an ideal type of nation in $\ulcorner$Politeia$\lrcorner$. and he founded a Akademeia in order to realize his dreams. In his course of education. he put emphasis on the problem of health. He extended poetry education for mental health and physical education for physical health. He placed high value on mental health above physical health. and poetry education corresponds to our reading education of today. He perceived that reading had a considerable influence on mental health promotion. According to his assertion, life style, too. had something to do with health condition. To lead a simple. temperate life makes one' health promote, on the other hand, to lead a complicated, intemperate life makes one' health injure. Morever, he approved of a eugenic marriage and the law of jungle. If one is unable to take care of one' health oneself. he would rather die than live. We cannot accept this proposal by general consent. but we cannot be too careful of our health. We can draw out a philosophy of health from Platonic View of Health. For example. the importance of health education. the preference of mental health. the influence of reading education. and responsibility for self-care, etc. We need to establish a philosophy of health scientifically by lasting study of records.
Purposes: Purposes of this study were to assess the needs of health education of residents and to determine the difference according to their general characteristics in a community. Method: Subjects consisted of 599 residents who live in the vicinity of M Catholic University, S dong, M city, Jeollanam do. Data were collected by 6 research assistants, using a self reported questionnaire from July 1, 2003 to July 31, 2003. Results: Subjects were mostly female (58.8%). 20 30 years old(45.2%), married (70.1%), high school graduates (42.1%), have an occupation(73.1%). have incomes less than 1.000,000 won(54.2%) and have a religion(59.8%). and the family type of the subjects was primarily nuclear(64.1%). The need for education about 'family health care management and medical examination' was the highest in 8 domains. The need for education about 'cancer' was the highest and 'family health care', 'stress and strategies', 'introduction of medical examination' and 'oral care' followed in 41 items. The differences in the needs of health education in all domains was found according to subjects' general characteristics. Conclusion: Further research is needed to develop a health education program based on participants' needs and general characteristics.
Background: The most important thing to strengthen primary care is to prove that the continuity of primary care is an essential area for good health outcomes. The purpose of this study is to analyze the effect of outpatient continuity of primary care on the hospitalization experience of diabetes mellitus in new diabetic patients. Methods: Using the Korean National Health Insurance Service national sample cohort (NHIS-NSC 2011-2015) data, 3,391 new diabetic patients in 2012 were selected for the study. Multiple logistic regression was performed to investigate the effect of outpatient continuity of primary care on hospitalization in new diabetic patients. Results: The outpatient continuity of primary care in new diabetic patients was measured by the continuity of care index, which showed that 69.4% (n=2,352) were high level and 30.6% (n=1,039) were low level. Patients who had high continuity of primary care at the early stage of diabetes diagnosis showed 3.49 times more likely to maintain high continuity of primary care in the second year (95% confidence interval [CI], 2.72-4.49). Patients with low continuity of primary care for 2 years from the initial diagnosis of diabetes were 2.56 times more likely to be hospitalized due to diabetes than those who did not (95% CI, 1.55-4.25). Conclusion: This study identified the need for policies to increase the continuity of primary care for new diabetic patients and could contribute to lowering the admission rate of diabetic patients if the policy for this would work effectively.
Thus, I studied Health services supplied by local health centers and the requirements of the inhabitants visiting the health care facilities. The purpose of this study was to provide basic material for the establishment of Health care policy and the development of health care businesses. The target places for this study were 4 health centers; Chungrang-Gu, Nowon-Gu, Eunpyung-Gu, Songpa-Gu, with 509 mothers who were visiting the Centers. The question items of this study concerned a total of 124 health-related services provided by the Health Centers. The data was collected for a total of 92 days; July 1st~September 30th, 1999. 800 questionaries were distributed and 559 answered, 509 were analyzed finally. The collected data were processed using the SAS program to get mean, standard deviation, percentage. Open questions were made to reveal the opinions of mothers using the health care center. The results were as follows : 1. Among the participants of the study, 49.7% were 25~29 years of age, 84.3% were house wives by current occupation, 56.2% were from 4~6 person households. 52.1 were educated at a high school level, and 43.6% were educated at a collage level. 2. The highest percentage(53.6%) of the users were spontaneous in their utilization of health care center. The major reason for using the Health care center is that it is free to 65.8% of those covered and of low cost to 19.3% of those covered. 3. The satisfaction level of those using the health care center appeared to be generally high. The general average value showed up as $3.027{\pm}0.519$. 4. The level of recognition of the value of the heath care center services was high, particularly in the basic item of diagnoses of pregnancy, particularly in the basic item of diagnoses of pregnancy. However, the satisfaction level of health care education In pregnancy is low at 20~40%. In the meantime, the level of recognition in breast- feeding benefits is high at 76.8%. 5. The rate of realizing health care center's service campaign was generally low at 10~20%. 41.3 of the people knew the advertizing material of the health care centers. 32.4% of the people knew the advertizing material of the health care centers. 32.4% of the people knew the campaign of health care center for importance of breast-feeding benefits. 30.1% of the people knew the campaign for testing congenital mechanism disease. In the meantime about 50% was recognised the health care centers campaign for the importance and time of infants vaccination. 6. The need for enhancement of health care center services was shown to be high as $3.266{\pm}0.676$ as an average, chicken pox vaccination being the most highly requested at $3.565{\pm}0.587.$. 7. Among the open questions, the additional service to be provided were as follows ; increase of campaign of health care center services, furnishing advertizing books in public locations, providing shuttle bus service to the health care centers, extension of desire for preventative injections, rest and play areas for the children of the families serviced, consultation rooms, etc.
Purpose: This study was conducted to explore the meaning and contents of high-quality aged care facilities and provide basic data for evaluation of service quality in such facilities. Methods: The focus group interviews and participants consisted of two user groups, for a total of 16 family caregivers of the elderly living in facilities and four service provider groups, for a total of 26 chief managers and caregivers working in aged care facilities. All interviews were recorded and transcribed as they occurred. Content analysis was used and debriefing notes were referred to in order to analyze the data. Results: Four themes of a high-quality aged care facility emerged from the analysis; 1) a place to rest for comfortable later years; 2) systematic value-based management; 3) providing professional care; 4) comprehensive service provision in response to diverse needs. Conclusion: The findings of the study showed the importance of client centered care and ethical mindset of providers, which had not been included in the existing quality evaluation programs. Based on these results, medical treatments, end-of-life care and more comprehensive and extended services including family care need to be provided in facilities to ensure good quality aged care.
Early Head Start (EHS) can provide services to a child and family from pre-birth until the child is three years old. Services are comprehensive, intensive, individualized and flexible according to child and family needs, and integrated with community service delivery systems. The local program designs and operations were developed and carried out within the framework of the Head Start Revised Performance Standards, which included specific provisions for services to pregnant women, infants and toddlers and emphasized prevention, early intervention, safety, and health education. As with preschool Head Start, EHS programs are required to make available 10 percent of their enrollment for infants and toddlers with disabilities as defined by Part C regulations of the state in which the program operated. Quality child care has become a priority for EHS. A majority of EHS children need child care, and the quality is important to their development. An evaluation of EHS in 17 programs selected from the first program cohorts showed that the program had significant and positive impacts on a wide range of parent and child dimensions, some with implications for children's later school success. Among the issues for policy attention identified by American EHS for the Korean system are: - The need to create a comprehensive infant/toddler care system - The need to address access of teachers for young children - The need to improve quality.
It is important to asess the risk factors of parenting and provide early intervention for promotion of the maternal caretaking ability. The purpose of the study was to identify the maternal burden of caretaking, the supporting and the educational need for the caretaking activities of the mother of infant. Sixty three mothers of infants who visited the wellbaby clinic of S university hospital and one health center during the period of November 1st, to 30th in 1996 comprised the subjects of this study, Data were gathered through the instruments that were developed by researcher. Statistical analysis of this study was used ANOVA and Pearson correlation. The results were as follows : 1) The mean score of the maternal burden of caretaking was 22.06. The maternal burden of caretaking was significantly high in the mothers who had vaginal delivery compare with the mothers who had caeserean section and in the muthers who gave artificial feeding compare with the group of breast or mixed feeding. 2) The mean score of the support need for the caretaking activities was 30.69. The support need for the caretaking activities was significantly high in the mothers who had the second child, compare with the mothers who had first or third child. And the support need for the caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'immunization' and 'prevention of accident' on the support need for the caretaking activities were relatively high. 3) The mean score of the educational need of caretaking activities was 29.3. The educational need of caretaking activities was significantly high in the mother who had the second child compare with the mothers who had first or third child. And the educational need of caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'emergency care' and 'prevention of accident' on educational need of caretaking were relatively high. 4) The maternal burden of caretaking was not correlated with the support need or the educational need of caretaking activities. But the support need of caretaking activities was significantly correlated with the educational need of caretaking activities. 5) The support and educational need of caretaking activities were significantly high in the mothers who wanted home care for caretaking their infants. Through the study, it was found that there is considerable maternal burden of caretaking as well as the support and educational need on the caretaking activities in the mothers whose child is young. Therefore developing the systematic and effective program is needed to meet the mother's need. The results of this study will be useful resources to develop the program. On the other hand, it can be recommanded that home health care will be one of the approach to support the mothers caretaking activities.
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