Purpose: The purpose of this study were to examine the need of community care services and the influencing factors of the need in the family care givers of hospital-based home care patients. Methods: Data were collected from 256 family caregivers, who were recruited from 10 hospitals in a metropolitan city. A structured questionnaire on the characteristics of caregivers, resources, and patients was administered. Also, questions on the need of community care services were added. Logistic regression analysis was used to identify the influencing factors of the need for community care services. Results: The participant needed more transportation service, lease of health care devices, visiting bath, caring, visiting hair dressing than that of housekeeping, short-term care, and day care service. Various variables from the three factors were found to be influenced on the need of community care services. Conclusion: The accessibility of the higher need of community care services should be increased for hospital-based home care users. Also, the factors of Family care giver, Resource, and Patient might be considered to provide community care services of hospital-based home care users.
Purpose: The purposes of this study were to examine the differences in need, necessity, performance, barriers, and effectiveness of workers' health promotion program and to determine the influencing factors in effectiveness of workers' health promotion program by business types. Methods: Subjects were participants of an education held by Korean association of occupational health nurses and a survey was self-reported. Survey items were developed by researchers through literature review. It included general characteristics of occupational health providers and worksites, need, necessity, performance, barriers and effectiveness of workers' health promotion (WHP) program. The total number of worksites was 168, manufacturing/construction was 76 (45.2%), other services were 52 (31.0%), and healthcare services were 40 (23.8%). We used ${\chi}^2test$, ANOVA test, correlation analysis, and multiple regression analysis. Results: There were differences in need, necessity and performance of WHP by business types. In healthcare services, WHP had statistically significant effectiveness to reduce turnover rates. And the influencing factors of WHP's effectiveness were workers' need in manufacturing/construction, health provider's career in other services, and perceived necessity in healthcare services. Conclusion: Based on this result, we propose differentiated strategies depending on the business types for effective workers' health promotion program.
The aim of this study was to assess the people's need for visiting health services in a rural area. In recent years, the great concern for the visiting health services has aroused in Korea. Stratified cluster sample for a household survey was used to select 1,255(8.4%) Households from Yonchon county. This study was undertaken from July 26 to August 7 in 1993. Medically defined need, usually expressed by the prevalencies or rates of specific disease, was evaluated with the use of criteria established by medical and nursing professors and expressed by the percent of specific objects for the visiting health services. Perceived need represented by the acceptability for the visiting services and willingness to paying for it, also, evaluated. The major results were as follows : 1. Of the 348 patients with hypertension, 201 were the non-compliant patients, the rate of the non-compliant hypertension patients in 4,577 study population was 7.4%. 2. Of the 141 diabetic patients, 73 were the non-compliant patients, the rate of the non-compliant hypertension patients in 4,577 sample population was 2.7%. 3. The number of patients with severe musculo-skeletal disease was 24, the rate was 0.9% above the age 30. 4. Of the 514 elderly, 33 were the elderly without any family member, the rate was 8.4%. Those with severely decreased activity of daily living were 13. 5. Infants with high risks were 12, pregnant women and neonates were 5, patients discharged within 1 week and with special equipments such as peritoneal dialysis, stoma, TPN etc. were 17, and patients with cancer were 5. Total number of the objects needed visiting health services was 752(18.43%) of the 4,577 study population. Perceived need evaluated were as follows; The acceptance rate of visiting health services was 74.9%, The kinds of visiting health services such as family health protection and promotion, early detection of hypertension, physiotherapy, health education and counseling were needed in the order of high rate The price willing to pay for visiting health services per visit was about 3,000-5,000Won. In conclusion, Visiting health services programme to be developed should have priority to the prevention of complications of chronic disease such as hypertension, diabetes milletus, elderly disease and health promotion.
Purpose: This study was done to assess the educational needs that should be considered in developing curriculum for staff in charge of public health services in public hospitals. Methods: The participants in this study were staff in charge of public health services in 130 public hospitals. The Borich's Needs Assessment Model which analyzed the relation of 'required competence level' and 'present competence level', was utilized. Data were collected from October to November 2007 using a structure self-report questionnaire. The return rate was 66.9%. The Cronbach's alpha score was 0.959. Results: The mean scores for 'required competence level', 'present competence level' and Borich's need were 4.02, 3.44, and 2.30 respectively. According to public health service items, 'strategies to recognize the present condition and analyze problems' had the highest score for Borich's need, but 'establishment of annual or monthly objectives' had the lowest score for Borich's need. Conclusion: Education was found to be very important for staff carrying out public health services. Ultimately the results of this study may be utilized to develop education program for staff carrying out public health services in public hospitals.
Kim, Woo-Rim;Nam, Chung-Mo;Lee, Sang-Gyu;Park, So-Hee;Kim, Tae-Hyun;Park, Eun-Cheol
한국의료질향상학회지
/
제25권2호
/
pp.44-55
/
2019
Purpose: To investigate whether changes in Medical Aid (MA) status are associated with unmet need and catastrophic health expenditure (CHE). Methods: Data from the 2010 to 2014 Korea Health Panel (KHP) were used. The impact of changes in annual MA status ('MA to MA,' 'MA to MA Exit,' 'MA Exit to MA,' and 'MA Exit to MA Exit') on unmet need (all-cause and financial) and CHE (10% and 40% of household capacity to pay) were examined using the generalized estimating equation (GEE) model. Analysis was conducted separately for MA type I and II individuals. Results: In 1,164 Medical Aid type I individuals, compared to the 'MA to MA' group, the 'MA to MA Exit' group had increased likelihoods of all-cause and financial unmet need. This group also showed higher likelihoods of CHE at the 10% standard. The 'MA Exit to MA Exit' group showed increased likelihoods at the 10% and 40% CHE standards. In 852 type II recipients, the 'MA to MA Exit' group had higher likelihoods of CHE at the 10% standard. Conclusions: Type 1 MA exit beneficiaries had higher likelihoods of all-cause and financial unmet need, along CHE at the 10% standard. Type I 'MA Exit to MA Exit' beneficiaries also showed higher likelihoods of CHE at the 10% and 40% standards. In type II recipients, MA exit beneficiaries had higher likelihoods of CHE at the 10% standard. The results infer the importance of monitoring MA exit beneficiaries as they may be vulnerable to unmet need and CHE.
Objectives: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. Methods: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. Results: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. Conclusions: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.
Purpose: This study was to investigate the needs of health & community services among the disabled at home in rural areas. Methods: The subjects were 146 persons with disabilities living in J-gun. The questionnaire was based on the needs of 8 categorical services. Data were analyzed using frequency, percentage, mean, standard deviation, minimum, maximum, t-test, one-way ANOVA and Scheffe test. Results: Among the respondents, 27.4% visited the public health center in community for rehabilitation therapy. The average score of need was $2.62{\pm}.79$: education services $(2.92{\pm}1.05)$; medical services $(2.81{\pm}.82)$ nursing care services $(2.75{\pm}1.08)$; connection services $(2.62{\pm}1.20)$;, housing services $(2.60{\pm}1.09)$; emotional services $(2.41{\pm}1.03)$; other services $(2.24{\pm}1.06)$; and support of self-sustenance service $(1.92{\pm}1.15)$. The items in highest need were medical checkup (70.7%), medication (62.1%), traditional oriental therapy (60.4%) and physical therapy (58.9%), and those of lowest need were device repair (8.7%) and guidance of facility admission (7.1%). Needs were significantly different according to age (F=4.751. p=.001), employment status (t=2.108, p=.037) and medical fee payer (F=5.061, p=.002). Conclusion: The needs of education & medical services were relatively high. Demographic factors were statistically significant in determining needs. For the disabled at home in rural areas, more various services or programs should be executed based upon the needs and characteristics of based upon the needs and characteristics of the subjects.
Although 19 years have passed since the enforcement of the Framework Act on Health and Medical Services, the Plans for Development of Health and Medical Services has not been established. This Plan is a 5-year basic long-term plan that covers the whole of health and medical services. This Plan should point to the direction of 30 long-term plans of healthcare, and this Plan should serve as a combination and coordination of 30 long-term plans and 22 related laws. The United States, the United Kingdom, and Japan have established long-term healthcare plans (4-, 10-, and 20-year plans, respectively). The long-term health plan of the United States has been approached bottom-up, those of the United Kingdom and Japan have been approached top-down. The rapid environmental changes that Korea is and will be experiencing emphasize urgently the need for establishing the Plan for Development of Health and Medical Services.
The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.
This study was conducted to examine the recognition level of the people on oriental medical Services and the need for it's improvement. Data were collected from 1174 residents in Daegu metropolitan city and Gyungbuk province. According to the satisfaction level with each items of oriental medical services, the respondents had positive views on efficacy, kindness, and side-effects. They, however, had negative view on the cost of oriental medical services. In regarding to the priority of improvement of oriental medical system, 'expansion of insurance benefit package' ranked first. Followed by 'safety of herbal medicine(heavy metal/pesticides)', 'improvement of scientific methods and diagnostic technique' etc. For the further development of oriental medical services in the consumer - focused and evidenced-based health care environment, much attention to implement relevant health policy reflecting user's need positively should be made.
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