• Title/Summary/Keyword: Local Community Care System

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A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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Standing Issues and Policy Tasks of the Korean Dental Community - The direction of reforming the country's health insurance system (치과의료계의 현안과 정책과제 - 건강보험제도의 현안과 발전방향 모색)

  • Lee, Soo-Ku
    • The Journal of the Korean dental association
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    • v.48 no.1
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    • pp.6-11
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    • 2010
  • Amid the rapid transitions in both local and international markets, the Korean dental industry is facing more challenges than at any time in its history. This paper tried to address some of the key issues faced by the industry as well as the policy issues and I direction of implementation that the Korean Dental Association (KDA) is expected to tackle. First, the direction of reforming the country's health insurance system was examined with emphasis on the expected changes in and improvement of the fee-for-service reimbursement system (FFSRS) and medical reimbursement system (MRS). With FFSRS, the most urgent issue would be ameliorating the current lop-sided, unreasonable reimbursement system that prevents suppliers from voicing their opinions. To help achieve that goal, the limited authority and responsibility of the president of National Health Insurance Corporation (NHIC) as one of the contract-making parties must be clarified. In addition, the functions of NHIC's Health Insurance Finance Committee must be restricted; at the same time, the panel organization of the Health Insurance Policy Review Committee needs to be reformed to embrace greater democracy. As with MRS, the government is considering a block budget bill to help promote efficiency in employing and managing the health insurance fund. Policymakers must understand that the implementation of such proposal could exacerbate an already dire situation. Improving MRS requires meeting the following preconditions: (a) the structurally vicious cycle of small charge-small salary needs to be resolved, and a certain percentage of fee raise must be guaranteed on a yearly basis to help adjust the fee system to a more realistic level; (b) the supply-and-demand balance in producing health care professionals must be improved including the prevention of oversupply of doctors, nurses, etc., and; (c) institutional strategies must be provided to enhance the quality of medical care and ensure academic advancement in health care disciplines.

Clinical Nutrition Services of a Long-term Care Hospital in Korea (전국 요양병원에서의 임상영양서비스 실태 조사)

  • Um, Mi Hyang;Lyu, Eun Soon;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Park, Yoo Kyoung
    • Korean Journal of Community Nutrition
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    • v.20 no.3
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    • pp.220-235
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    • 2015
  • Objectives: The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians. Methods: Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. The participating hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospital s and 223 dietitians completed the survey of clinical nutrition service s and job satisfaction questionnaires The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. Results: The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. KOIHA (Korea Institute for Healthcare Accreditation) accreditated hospitals showed only 50% performance rate of nutrition service evaluation area. This shows that after achieving KOIHA accredition, many hospitals do not emphasize the performance of nutritional services. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. Linear regression analysis results showed that the "hospital adequacy grade" type was a significant predictor of job satisfaction level for two areas (working conditions & relationship). Conclusions: There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service s in long term care hospitals. Therefore, government and local hospitals have to work on implementing nutritional programs and policies for improved service and care.

The Inter-ministries Linkage Method Comparison of Elementary Care Policy Fields in Korea and Japan, and Implications for The Elementary Child Care Classroom of Korea (한국과 일본의 초등 돌봄 정책 부처 간 연계방식 비교와 초등돌봄교실에 주는 시사점)

  • Kim, Soo-Dong;Jeong, Yeong-Mo
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.6 no.4
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    • pp.279-288
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    • 2016
  • This study compares interagency linkage in the area of the elementary child care policy in korea and japan and derives the implications related to the elementary child care classes of korea. This study researches linkage method between the ministries in korea and japan focused on the background, the process, the current operating system. The elementary child care service policies of the korea & japan are analysed comparatively in terms of background, budget, goal, linkage ministries, basis of law, administrative units and on the basis of those analyses, the implications related to the elementary child care service policy of korea are derived. The derived implications are as follows : first the sound development of the child becomes the foundation of the development of school and community. Community and school have to strengthen cooperation. Second, child care policy is not the alternatives for overcoming fragmentary problems but has to be carried out considering them variously in broad prospective. Third, korea has to find the effective linkage method between the ministries. Fourth, find the way which interagency policy can be merged as a hub for school. Fifth, korea has to find the way transferring the central operating body from the principal in school to the local government to operate the elementary child care classes successfully. Sixth, positive interest and continuous support of the top policy makers is needed.

A Study on the Inhibiting Factors of Case Management in Child Welfare Facilities (아동복지시설 사례관리수행 저해요인에 관한 연구)

  • Kim, Hyeun Ju
    • Journal of the Korea Convergence Society
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    • v.8 no.2
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    • pp.183-196
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    • 2017
  • The purpose of this study is to investigate the effectiveness of case management in child welfare facilities to determine what the inhibiting factors as well as complementary factors are. For this purpose, data from 181 workers in community children's centers and 96 workers in child protection agencies and foster care centers were analyzed, the analyzed by using SPSS 21.0 program. In the case of community children's center interpersonal skills, case management guidelines, super vision, and network utilization were the influential factors while in other child welfare facilities, personal inhibitory factors, social welfare work experience, case management experience, and network utilization were the affecting factors. The implications reveal that social welfare practice should enhance the interpersonal skills of the workers, strengthen the supervision system, and provide a clear case management guideline. It is also important to set up a network of all local child welfare facilities and strengthen cooperation and mutual support among the institutions within the network.

Factors Influencing Medical Care Utilization according to Decline of Region: Urban Decline Index and Medical Vulnerability Index as Indicators (지역쇠퇴 유형별 의료이용행태 영향요인: 도시쇠퇴 지표와 의료취약지 지표를 활용하여)

  • Jeong, Ji Yun;Jeong, Jae Yeon;Yoon, In Hye;Choi, Hwa Young;Lee, Hae Jong
    • Health Policy and Management
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    • v.32 no.2
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    • pp.205-215
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    • 2022
  • Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

The meaning and challenges of the introduction of the Customized Care Services for Older Adults (노인맞춤돌봄서비스의 도입 의미와 과제)

  • Chon, Yongho
    • 한국노년학
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    • v.40 no.4
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    • pp.599-616
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    • 2020
  • The South Korean government has introduced a new Customized Care Service for Older Adults by eliminating the six existing care services for them since 2020. It is a significant change of care service system for older adults and the service would play a key role in providing preventive services for them. The aim of the study is to examine the meaning and tasks of the introduction of the Customized Care Services for Older Adults in South Korea by using the framework of Gilbert and Terrell. The study found that the new service was designed under the government's policy contexts of the establishments of public-based social service providers and the emphasis of community care, and it has brought about a number of significant institutional changes of care system in terms of allocation, benefits, delivery, and finance. The institutional coverage of the service was increased to lower 70% of older adults and a large number of kinds of health and social care services would be provided for them. The sphere of living was set in each local area and the new service providers are entirely in charge of providing the services in each sphere. The financing system was changed to support service providers by providing government subsidies. Although a number of positive results would be expected to occur for the elderly, it is likely that some challenging tasks would happen in the fields as follows: the inadequate coverage, the vagueness of the application of self-care principle and the decrease in the amounts of direct care services, the inappropriate area of service provision, and the supplier-oriented provision of services rather than user-oriented.

Development of Evacuee Support Using Heart Rate Variability

  • Hayashida, Yukuo;Kidou, Keiko;Mishima, Nobuo;Kitagawa, Keiko;Oh, Yong-sun;Yoo, Jaesoo
    • International Journal of Contents
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    • v.13 no.2
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    • pp.1-5
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    • 2017
  • Residents under hazard and disaster conditions should be evacuating to the pre-assigned nearest safety facilities, community hall, local schools, friend's houses, etc. in a safety zone, quickly as soon as possible. The small percentage of evacuees shows serious economy class syndrome after the quake, because those people are forced to a stressful dairy evacuee-life in scattered homes and/or in-vehicle, for instance. Then, we consider on supporting evacuees using heart rate variability, Geospatial Positioning System (GPS) and WiFi functions of a smartphone, and Web-server on the Internet to keep their health in good conditions.

Practical Examples of the Comprehensive Strategy of Japanese Dementia Policy: Kumamoto Model by Kumamoto Province (일본 인지증 정책 종합 추진전략의 실천 사례: 쿠마모토현의 쿠마모토 모델)

  • Joo, Jungmin;Kwon, Yong-Jin
    • Health Policy and Management
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    • v.29 no.1
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    • pp.11-18
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    • 2019
  • The purpose of this research is to introduce the best practice of the Japanese national dementia strategy and explore implications to the Korean national dementia strategy. Interview was conducted among professions those who is in charge of Kumamoto dementia care practice in Kumamoto province, upon review of related literature and public documents. The Kumamoto model is implemented by the department of neuropsychiatry in public university hospitals, which can offer dementia-specialized medical services. Medical centers for dementia in public university hospitals play a leading role for managing practice and training local dementia centers specialist, coordinating medical services among medical institutions and community welfare facilities. In reference to the Kumamoto model, the Korean national dementia strategy can find implications in the direction of current system, specifically its approaches toward policy governance.

A Study on the Types of School Accidents and First Aids at Elementary, Middle, and High Schools in a Local Province (일 지역 초.중.고등학교 사고 유형과 이에 따른 응급처치 실태)

  • Cho, Byung-Jun
    • Journal of the Korean Society of School Health
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    • v.20 no.1
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    • pp.45-52
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    • 2007
  • Purpose: The purpose of this study was to examine the types of school accidents and their first aids at Elementary, Middle, High Schools in a local area. Methods: The subjects were 1062 students who have had episodes of school accidents from 730 (Elementary = 429, Middle = 188, High = 113) schools in Chungnam province from January to December, 2006. Data were collected from accident-related record from school nurse and 'School Safety Fund', and analyzed using the SPSS Version 13.0 programs and the results and conclusions are as follows: Results: The proportion of school accidents occurred were in middle(0.43%), high(0.35%), primary(0.30%) school students. And the most frequent type of accident was fracture and then sprain. Most school accidents broke out in playground during resting time, and followed by physical education class. The most frequent cause of school accidents was carelessness and first aid was fixation the injury. Conclusion: Based on these findings, school-based and continuous safety education programs and emergency care system within school and in community can be suggested in collaboration with health-related resources. Further longitudinal study to identify causes and kinds of school accidents and can also be recommended.