• 제목/요약/키워드: Health service delivery

검색결과 337건 처리시간 0.026초

Barriers to Cervical Screening among Pacific Women in a New Zealand Urban Population

  • Foliaki, Sunia;Matheson, Anna
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1565-1570
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    • 2015
  • Background: In Aotearoa/New Zealand cervical screening programmes have reduced cervical cancer; however, half of cervical cancer cases among Pacific women are found among clients who had not attended cervical screening. Hence, we set out to determine health provider perspectives on barriers that prevent their services reaching Pacific women within Aotearoa/New Zealand. Materials and Methods: Twenty semi-structured interviews were conducted with health care providers, Pap smear takers and community workers in the Wellington region. Participants were asked their views on factors that enabled and/or constrained the participation of Pacific women in their cervical screening services. Results: Six interrelated themes influencing participation in cervical screening among Pacific women in the Wellington region were apparent: the funding and practice of service delivery; family always coming first; the cost of screening services; type of employment; the appropriateness of information; and attitudes to self and screening. Conclusions: Determining specific ethnic group actual health needs and meeting them contributes to overall improvement in New Zealand's health status. The results identified the need for improvements to the delivery of screening services including adapting cervical screening services to the requirements of Pacific women through more outreach services at alternate clinic hours; culturally appropriate practitioners; the ability to take up opportunities for health checks and foster long-term relationships; as well as appropriate monitoring and evaluation of approaches. Funding and reporting relationships also need to be compatible with the goal of improving outcomes for Pacific women. Further research into client voices for their particular needs to compliment the service provider perspective as well as minority groups is called for.

Exploring the Feasibility of Differentiating IEEE 802.15.4 Networks to Support Health-Care Systems

  • Shin, Youn-Soon;Lee, Kang-Woo;Ahn, Jong-Suk
    • Journal of Communications and Networks
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    • 제13권2호
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    • pp.132-141
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    • 2011
  • IEEE 802.15.4 networks are a feasible platform candidate for connecting all health-care-related equipment dispersed across a hospital room to collect critical time-sensitive data about patient health state, such as the heart rate and blood pressure. To meet the quality of service requirements of health-care systems, this paper proposes a multi-priority queue system that differentiates between various types of frames. The effect of the proposed system on the average delay and throughput is explored herein. By employing different contention window parameters, as in IEEE 802.11e, this multi-queue system prioritizes frames on the basis of priority classes. Performance under both saturated and unsaturated traffic conditions was evaluated using a novel analytical model that comprehensively integrates two legacy models for 802.15.4 and 802.11e. To improve the accuracy, our model also accommodates the transmission retries and deferment algorithms that significantly affect the performance of IEEE 802.15.4. The multi-queue scheme is predicted to separate the average delay and throughput of two different classes by up to 48.4% and 46%, respectively, without wasting bandwidth. These outcomes imply that the multi-queue system should be employed in health-care systems for prompt allocation of synchronous channels and faster delivery of urgent information. The simulation results validate these model's predictions with a maximum deviation of 7.6%.

A Study on Service Quality and Customer Satisfaction in Nigerian Healthcare Sector

  • Potluri, Rajasekhara Mouly;Angiating, Gift
    • 산경연구논집
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    • 제9권12호
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    • pp.7-14
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    • 2018
  • Purpose - The core objective of the research is to explore the quality of services provided by the Nigerian health care sector that lead to know the satisfaction levels of the consumers. Research design, data, and methodology - After a meticulous literature review, the researchers administered a two part questionnaire to know the service gaps and satisfaction levels of the customers. The research carried out with a sample of 400 respondents but received only 150 responses from the residents around Adamawa state. The collected data was edited, coded, and analyzed with the SPSS latest version with the descriptive and inferential statistical tools. Results - Majority of the respondents expressed their discontentment over the responsiveness of the service providers when compared to tangibility and reliability quality variables. There is no relationship between the quality variable tangibility and overall satisfaction. Related to the overall satisfaction, 42 percent of respondents have neutral perspective indicated that they are either satisfied or dissatisfied as against the 43.3 percent of dissatisfied customers. Conclusions - This research proffers invaluable information to the entire Nigerian health-care sector to review their existing delivery of services to improve patient satisfaction. This research is first of its kind concentrated to know the quality of health-care services and customers overall satisfaction in Nigeria.

지역에 따른 의료이용의 차이 분석 (An Analysis Of The Differences In Medical Use By Region)

  • 서우순;김재현;이옥희
    • 한국병원경영학회지
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    • 제25권1호
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    • pp.13-20
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    • 2020
  • Purposes: This study has the purpose to the improvement of health promotion for local residents through delivery of high-quality medical service by improving imbalance of medical use and seeking an improvement plan for accessibility of effective medical service by understanding the pattern of medical use by region. Methodology: As for the method, this study derived results at the significance level of p<0.05 through chi square test(χ2 test) and Generalized Estimating Equation(GEE) SAS 9.4 version by using the data of the 7th Korean Longitudinal Study of Ageing 2018. Findings: Study results show that local residents use medical service such as hospitalization care and outpatient visit more as compared to the residents in Gyeonggi-do/large or medium-sized cities. The more the number of chronic disease, the more they select hospitalization care rather than outpatient visit. Results also show that patients engaged in labour tend to select outpatient treatment rather than hospitalization treatment. Meanwhile, severity of disease turned out to be higher amongst medical care beneficiaries than that of national health insurance patients when comparing the types of medical security. Practical Implications: In stead of solving the problem of the difference in medical use by region from the aspect of income and economic level, an integrative solution shall be provided putting viewpoint on the social phenomenon suited to the changes of the times. This study suggests a plan for using a health and medical community care center that acts as a gate keeper of regional medical service.

여성결혼이민자의 보건의료이용실태와 보건의료요구도 조사 (Married Immigrant Women's Utilization of Health Care and Needs of Health Services)

  • 김춘미;박명숙;김은만
    • 지역사회간호학회지
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    • 제22권3호
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    • pp.333-341
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    • 2011
  • Purpose: The purpose of this study was to analyze married immigrant women's utilization of health care and their demand for public health care services. Methods: This study was conducted through descriptive survey with 102 married immigrant women in 2 cities, and survey was done from November, 2010 to May, 2011. Results: The results were as follows. Of respondents, 70% were using medical services in Korea and only 38.2% of them were satisfied with services. Major difficulties in using health care services were 'access problem' (35.7%), 'communication problem' (27.7%), and 'medical cost' (19.8%). The respondents' main sources of health information were family (56%), health care center (15%). The types of health information and education demanded by respondents were children's health care (22.1%), pregnancy and delivery (21.1%), and common disease care (20.0%). The most wanted services from public health care institutions were vaccination (24.5%), health promotion (21.5%), and leisure activity programs (20.6%). There was a statistically significant difference in period of immigration and public health care demands. Conclusion: For married female immigrants, it is recommended to provide tailored public health care services such as outreach service and visiting nursing care service, and to set up different language signs for common disease patients.

COVID-19로 인한 대학생의 건강행태 및 식생활 변화 (Changes in the Health Behaviors and Eating Habits of University Students Due to the COVID-19 Pandemic)

  • 김지현;정유선;정해옥;계승희
    • 한국식생활문화학회지
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    • 제37권3호
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    • pp.265-277
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    • 2022
  • This study investigated alterations in the health behaviors and eating habits due to the coronavirus disease 2019 (COVID-19) pandemic. An online survey was administered to 270 university students from September 22, 2021 to October 26, 2021. While the frequency of eating at home had increased during the COVID-19 pandemic compared to before the pandemic, there was a decrease in the frequency of eating out, drinking, and eating vegetables. However, the frequency of eating delivery, takeout, and convenience foods and the utilization of online shopping and delivery apps had considerably increased. In addition, when selecting menus, considerations of health, hygiene, and convenience were more important during the COVID-19 pandemic than before the COVID-19 pandemic. Physical activity more than 3 days a week had decreased, whereas sedentary time showed a proportionate increase. The percentage of people who perceived their health status to be worsening was determined to have increased during the COVID-19 pandemic. To prepare for the era of infectious diseases, future research needs to identify health behaviors and dietary problems by administering surveys that include a large sample size and participants of various ages. Moreover, health promotion and nutrition management plans should be prepared accordingly.

지역주민의 건강증진을 위한 인터넷 금연 강화 프로그램 개발 (Development of Internet Information Push-Delivery System Design of Smoking Cessation for Health Promotion)

  • 김영복;신준호;김신월
    • 농촌의학ㆍ지역보건
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    • 제29권2호
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    • pp.287-301
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    • 2004
  • 본 연구는 전남 곡성군 주민을 대상으로 지역사회 주민의 흡연율을 감소시키고, 금연 희망자의 금연 의지를 강화시키기 위해 2002년도에 개발된 곡성군 금연 클리닉의 '금연 개인관리 프로그램'을 중심으로 흡연 욕구 및 금연 장애요인에 대처하고, 금연 실천을 독려할 수 있는 금연 강화 프로그램을 개발하였으며, 프로그램의 지속적인 관리를 위해 지역 보건소가 수행의 주체가 되는 금연정보 지원시스템을 구축하는데 그 목적을 두었다. 본 연구의 중심이 된 '금연 개인관리 프로그램'은 지역 주민들에게 금연관련 정보 및 금연 기술을 제공하고, 금연에 관한 자기 통제력을 강화시키기 위해 개발된 인터넷 금연 프로그램이다. 그러나 '금연 개인관리 프로그램'은 참여자의 자발적인 행위를 원칙으로 하기 때문에 금연행위 유도 및 지속적인 금연 유지에 취약성을 지니고 있다. 따라서 이러한 단점을 보완하기 위해 성공적인 금연이 이루어질 수 있도록 개인별 금연실천을 돕기 위한 금연 강화 프로그램인 인터넷 금연 푸쉬 서비스를 개발하였고, 이에 관한 효과평가를 수행함으로써 프로그램의 문제점을 보완하기 위한 단계별 개선방안을 제시하고자 하였다. 연구결과를 요약하면 다음과 같다. 첫째, 금연 푸쉬 서비스를 활용한 금연 강화시스템은 개인별 금연실천을 돕기 위해 회원 가입이 이루어진 당일부터 금연 푸쉬 서비스가 제공되도록 설계하였으며, 모든 금연 푸쉬 서비스는 금연도전 프로그램의 단계에 맞추어 전자메일을 활용하여 제공되도록 고안하였다. 또한 각 단계별로 일정 형식에 따라 하루 1회씩 프로그램 참여 일정에 맞추어 제공하도록 설계하였다. 둘째, 금연 의지를 강화시키기 위해 금연 압력 메시지 및 경고 메시지, 성공 메시지를 개발하였으며, 금연 압력 메시지는 '금연 개인관리 프로그램' 에서 작성된 각 단계별 개인 정보를 활용하였고, 이전 단계에서 수립된 금연전략의 재확인 및 활용수준을 점검할 수 있도록 구성하였다. 셋째, 금연 푸쉬 서비스를 활용한 금연 강화 프로그램 및 운영 시스템을 평가하기 위해 군청 공무원 및 보건의료원의 보건직 공무원 중 흡연자로서 금연 강화 프로그램에 참여를 희망하는 10명으로 평가단을 구성하였으며, 1개월 간 시범 운영을 수행하였다. 넷째, 금연 강화 프로그램에 관한 내용 및 접근형식을 평가한 결과, 참여자의 기록 분량, 내용의 난이도. 시각적 효과의 불충분이 문제점으로 지적되었으며, 이를 개선하기 위해 참여자 중심의 기록방식을 클릭중심의 기록방식으로 전환, 참여자의 이해수준의 고려한 내용수정, 그래픽 요인의 추가 및 시각적 효과의 보완, 추구관리를 모듈 개발 등을 대안으로 제시하였다. 다섯째, 금연 강화 프로그램의 운영 시스템에 관하여 평가한 결과, 금연 압력 메시지를 제공하는 금연 푸쉬 서비스와 홈페이지와의 연계성 및 금연 개인관리 프로그램과의 연계성이 문제점으로 지적되었으며, 이를 보완하기 위해 홈페이지와의 링크 작업 개선 및 금연 개인관리 프로그램과의 링크 작업 새선, 휴대폰의 문자서비스(SMS) 기능 활용 등을 대안으로 제시하였다. 여섯째, 금연 강화 프로그램의 향후 단계별 개선방안을 프로그램의 일부 코드의 수정으로 가능한 즉시 개선방안과 프로그램 흐름의 일부 수정, 가감해야 하는 단기 개선방안, 프로그램 흐름의 대폭 수정 및 추가 모듈 개발이 필요한 중장기 개선방안으로 구분하여 제시하였다. 따라서 향후 금연 강화 프로그램을 지원하기 위한 금연자 추후관리 시스템이 구축되어야 하고, 지역 주민의 금연 실천을 독려하기 위한 다양한 컨텐츠가 개발이 선행되어야 하겠다. 또한 이를 지원하기 위해 지역 보건소 실무 담당자의 지속적인 교육 훈련 및 금연 사업을 위한 예산확보, 표준화된 금연사업 관리 지침서가 개발되어야 하겠다.

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응급실 서비스 만족도에 대한 환자 가족의 평가와 의료진의 인식 차이 (Satisfaction Gaps among Physicians, Nurses, and Patient Family in the Emergency Department)

  • 강경희
    • 보건행정학회지
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    • 제23권2호
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    • pp.145-151
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    • 2013
  • Background: The objective of this study was to explore patient family's evaluation of emergency department (ED) service satisfaction and to compare these with ED staff perception of patient family's evaluation. Methods: Based on two surveys of the National Emergency Medical Center: the 2008 National Survey for Recognition and Satisfaction towards Emergency Medical Services and the 2008 Opinion Survey of Emergency Medical Service Providers, satisfaction gaps among physicians, nurses, and patient family were evaluated by Kruskal-Wallis tests and Wilcoxon-Mann-Whitney tests. Furthermore, the factors associated with satisfaction of emergency medical service were identified by ordinal logistic regression models. Results: There were statistically significant gaps among physicians, nurses, and patient family in overall satisfaction with ED visit, length of stay in ED, enough explanation, physicians/nurses kindness, and ED facilities. Age and income in the patient family model, the number of beds in hospital, job satisfaction and year of service in the physicians model, and the number of beds in hospital, job satisfaction and the number of patients per duty hour in the nurses model were statistically significant factors associated with evaluation/ perception of ED service satisfaction. Conclusion: Patient satisfaction is an important indicator of the quality of care and service delivery in the ED. To improve and understand satisfaction in ED service, a dyadic view of the evaluation of service quality and satisfaction-that is, from the perspectives of both the patient and the emergency medical service providers-should be concerned.

35세 이상 고령 임산부 진료실적 추이에 관한 연구 (The trend of national health insurance service use among pregnant and postpartum women aged 35 years and older)

  • 황라일;김경하;윤지원;이정석
    • 보건행정학회지
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    • 제21권4호
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    • pp.585-598
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    • 2011
  • This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.

주요 상병 별 환자의 의료기관 선택성향 분석 (An Analysis of the Diseases Specific Medical Service Organization Selection Factors of Patients)

  • 윤경일;도세록
    • 한국병원경영학회지
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    • 제12권4호
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    • pp.1-21
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    • 2007
  • The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

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