• Title/Summary/Keyword: Local Health Center

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Comparative Analysis of Community Health Practitioner's Activities and Primary Health Post Management Before and After Officialization of Community Health practitioner (보건진료원의 정규직화 전과 후의 보건진료원 활동 및 보건진료소 관리운영체계의 비교 분석)

  • Yun, Suk-Ok;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.19 no.2
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    • pp.141-158
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    • 1994
  • To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

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Exposure Assessment and Asbestosis Pulmonum among Inhabitants near Abandoned Asbestos Mines Using Deposited Dust (폐석면광산 주변 지역의 주택 침적먼지의 석면 검출과 석면폐증의 관련성)

  • Ahn, Hoki;Yang, Wonho;Hwangbo, Young;Lee, Yong Jin
    • Journal of Environmental Health Sciences
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    • v.41 no.6
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    • pp.369-379
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    • 2015
  • Objectives: The lack of reliable information on environmental pollution and health impacts related to asbestos contamination from abandoned mines has drawn attention to the need for a community health study. This study was performed to evaluate asbestos-related health symptoms among residents near abandoned asbestos mines located in the Chungcheong Provinces. In addition, exposure assessment for asbestos is needed although the exposure to asbestos was in the past. Methods: Past exposure to asbestos among inhabitants near abandoned asbestos mines was estimated by using surface sampling of deposited dust in indoor and outdoor residences. A total of 54 participants were divided into two groups with (34 cases) and without (20 controls) diseases related to asbestos. Surface sampling of deposited dust was carried out in indoor and outdoor residences by collecting 105 samples. Deposited dust for sampling was analyzed by polarization microscope (PLM) and scanning electron microscope?energy dispersive x-ray spectrometer (SEM-EDX) to detect asbestos. Subsequently, the elements of the deposited dust with asbestos were analyzed by SEM-EDX to assess the contribution of sources such as abandoned mines, slate and soil. Results: Among the 105 samples, asbestos was detected by PLM in 29 (27.6%) sampling points, and detected by SEM in 56 (48.6%) sampling points. Asbestos in indoor residences was detected by PLM in four sampling points, and by SEM in 12 sampling points. Asbestos detection in indoor residences may be due to ventilation between indoors and outdoors, and indicates long-term exposure. The asbestos detection rate for outdoor residences in the case group was higher than that in the control group. This can be explained as the case group having had higher exposure to asbestos, and there has been continuous exposure to asbestos in the control group as well as the case group. Conclusion: Past residential asbestos exposure may be associated with asbestosis among local residents near abandoned asbestos mines. Odds ratios were calculated for asbestos detection in outdoor residence by logistic regression analysis. Odds ratio between asbestos detection and asbestosis pulmonum was 3.36 (95% CI 0.90-12.53) (p=0.072), adjusting for age, sex, smoking status and work history with multi-variable logistic regression by PLM analysis method.

Policies to Manage Drug Shortages in Selected Countries: A Review and Implications (주요국의 수급불안정 의약품 관리제도에 관한 고찰과 한국에의 시사점)

  • Inmyung Song;Sang Jun Jung;Eunja Park;Sang-Eun Choi;Eun-A Lim;Sanghyun Kim;Dongsook Kim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.106-119
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    • 2024
  • Drug shortage is a persistent phenomenon that poses a public health risk worldwide and occurs due to a range of causes. The purpose of this study is to review key policies to prepare for and respond to drug shortages in selected countries, such as the United States, Canada, and some European countries in order to draw implications. This study reviewed the reports and articles derived from search engines and Google Scholar by using keywords such as drug shortage and stock-out. Over the last decade or so, the United States have strengthened requirements on advance notification for disruption and interruption of drug manufacturing, established the Inter-agency Drug Shortages Task Force to promote the communication and coordination of responses, and expedited drug regulatory processes. Similarly, Canada established the Multi-Stakeholder Steering Committee on drug shortages by involving representatives from central and local governments and private sectors. Canada also adopted a tiered approach to the communication of drug shortages based on the assessment of the severity of the shortage problem and released a detailed information guide on communication. In 2019, the joint task force between the European Medicines Agency and the Heads of Medicines Agencies issued guidelines on drug shortage communication in the European Economic Area. The countries reviewed in this paper focus on communication across different stakeholders for the monitoring of and timely response to drug shortages. The efforts to protect public health from the negative impact of the drug shortage crisis would require multi-sectorial and multi-governmental coordination and development of guidelines.

Risk Assessment of Heavy Metals in the Vicinity of the Abandoned Metal Mine Areas (폐금속광산지역 중금속의 위해성 평가)

  • Lee, Jin-Soo;Kwon, Hyun-Ho;Shim, Yon-Sik;Kim, Tae-Heok
    • Journal of Soil and Groundwater Environment
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    • v.12 no.1
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    • pp.97-102
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    • 2007
  • An environmental survey from three abandoned metal mine areas was undertaken on to assess the risk of adverse health effects on human exposure to heavy metals influenced by past mining activities. Tailings contained high concentrations of heavy metals may have a impact on soils and waters around the tailing piles. In order to perform the human risk assessment, chemical analysis data of soils, rice grains and waters for As, Cd, Cu and Pb have been used. The HQ values for heavy metals via the rice consumption were significantly higher compared with other exposure pathways in all metal mine areas. The resulting HI values in three mine areas were higher than 9.0, and their toxic risk due to rice ingestion was strong in these mine areas. The cancer risk of being exposed to As by the rice consumption from the A, B and C mine areas was $5.1\;{\times}\;10^{-3}$, $6.8\;{\times}\;10^{-3}$ and $3.1\;{\times}\;10^{-3}$, respectively. The As cancer risk via the exposure pathway of rice ingestion from these mine areas exceeds the acceptable risk of 1 in 10,000 set for regulatory purposes. Thus, the daily intakes of rice by the local residents from these mine areas can pose a potential health threat if exposed by long-term As exposure.

A Study on the Clinical Statistics of Oriental Medicine Service in the Health Center (보건소내(保健所內) 한방의료(漢方醫療)에 대(對)한 임상통계연구(臨床統計硏究) (전주시(全州市) 완산구(完山區) 보건소(保健所) 중심으로))

  • Song, Beom-Yong;Yuk, Tae-Han
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.40-57
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    • 1997
  • The Background and Purpose It is done the study on the public health care of oriental medicine and improvement of its system recently, I think that these effect a good health care for a people through the public health care of oriental medicine. Since Woosuk university and Chonju-Wansan health center had taken upon the oriental medicine service in the health center in 1995, we have public favor from the local population. So in other to a study on the clinical statistics of oriental medicine service in the health center, I investigated general character, style of diseases, effect of treatments and the like for a paitents received oriental medicine treatments in there. Objective and Methods This study researched into clinical statistics for paitents received oriental medicine treatments in the Chonju-Wansan health center during one year period from January 4 1996 to December 26 1996. The number of object was 238 case of 234 persons. Results and Conclusions Analyzing these 234 persons, the proportion of males to females was 1 to 6.8. As for the distribution of age, the ages of 61 to 70 occupied 34.62 per cent in the ages of 51 to 90 occupied 88.89 per cent in the whole paitons. Therefor female was very highly more than male and paitents were for the most part, old ages(51years old and over). Musculoskeletal system and connective tissue disease of 238 case occupied 82.77 per cent. were the greatest proportion. At the duration of disease, 1 year to 5 years occupied 32.35 per cent, was the highest The grade Ⅲ was the most of the sign of paitents at first visit, it occupied 55.88 per cent. The good(++) and over effect of treatments occupied 62.18 per cent, the fair(+) and over effect of treatments occupied 78.99 per cent. As for the duration of treatment, the case of 2 times to 5 times visit occupied 34.03 per cent, was the highest. And the case of 2 times to 10 times visit was 4 times as good effect as the case of only one visit. By medication of treatment, O-Juk-San(五積散) occupied 32.21 per cent, was the greatest proportion, and Pal-Mj-Hoan(八味丸) occupied the second greatest proportion. Therefor the most of paitents had the chronic diseases and was diagnosed Sin-Yang-He(腎陽虛). The average 22.58 persons received acupuctural treatment a day, the average 0.58 persons received the moxibustion a day, the average 2.28 persons received venesection (bloodletting) a day. And others treatment performed physical therapy and the like. The case received treatment of the oriental and western medicine at the same time. marked 21 persons among 30 persons and had a good effect by 70 per cent. The average 26.95 persons received treatment of oriental medicine a day, the average 3.9 persons received the first medical examination a day.

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Musculoskeletal and Functional Status of Adults with Cerebral Palsy (뇌성마비 성인의 근골격계와 기능 실태)

  • Yoon Myung-ok;Kim Chung-sun
    • The Journal of Korean Physical Therapy
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    • v.17 no.1
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    • pp.43-68
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    • 2005
  • The purpose of this study was to report the physical status of adult with cerebral palsy who live in local community areas including Seoul, Busan, Daegu in Republic of Korea at 2004. 202-individuals with cerebral palsy(140 male, 62 female; mean age 31.9 years; range 19 to 64 years) were surveyed. Measures included a 29-item self-reported health status measure focusing on musculoskeletal status and functional performances. Adult cerebral palsy required continuous management for musculoskeletal and ambulatory function through therapeutic approach. This survey is restricted to population who had cared in welfare center for cerebral palsy in local community, so it needs to investigate home-residual adults with cerebral palsy and the population in rural community. The results were as follows: 1. Participants reported that they had a limitation of a daily of life activity due to musculoskeletal pain($43\%$), there was significant differences between a limitation of a daily of life activity and the decreased ambulatory function(p<.05). 2. Thirty six point six percentile of participants had the decreased ADL function, it was significant related with the impaired body location(p<.05) 3. Thirty nine point one percentile of participants who can independently gait had the decreased ambulatory function, it was significant differences with the usage of ambulatory assistive devices(p<.05). 4. There was significant differences ambulatory function both the body region with impairment and a grade of disability(p<.05). 5. Sixteen point three percentile of participants could not ambulate any more, there was significant differences between a age and a point of time for non-ambulation(p<.05). 6. There was significant differences between ambulatory function and physical activity(p<.05).

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A Current Status of Low Back Pain in Rural Peoples (일부 농촌지역 주민들의 요통발병 양상에 관한 연구)

  • Park, No-Chul;Kim, Yong-Kwon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.6 no.2
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    • pp.15-29
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    • 2000
  • Low back pain is generally defined as a complex symptom rather than a specific diseases entity, especially when musculoskeletal lesions of the low back, neurogenic, vasculogenic and discogenic lesions are present. Sixty to eighty percent of all human being have experienced low back pain once or more times during in their lifetime. Low back pain is a one of the commonest cause of physical impairment and induces disability the activities of everyday living or the activities of work. Today, low back pain plays important part for the loss of working capability from social, industrial field and individual daily life. But there are no study about incidence and prevention program of low back pain in rural peoples. This study was conducted to find out current status and characteristics related to low back pain in rural peoples(especially engaged in agriculture), so that could provide basic data to establish prevention program for them. The data were gathered from 301 rural adults(female 62.1%, male 37.9%) with low back pain by the structured interview in the 4 communities(south and north Gyeong-sang Do and Chung-cheong Do), and sampled at local hospital, local clinic, and health clinic center in May, 2000. The results were as followed. About one third of cases(35.5%) were aged from 60 to 69, 34.6% were smoker, and 91.4% not used to regular exercise. Low back pain frequently due to intervertebral articulopathy(42.5%), follewed by herniated intervertebral disk(19.9%), sprain(17.3%), vertebral dislocation(4.0%), and etc(16.2%). Above half of cases(56.5%) were a eight-hour workday, and 61.8% complained of low back pain during work. Mostly, period of agricultural experience was more than 20 years, and cultivated more than 2 crops. Low back pain is common to rural adults, therefore adequate resting time from work and lumbar strengthening exercise program needed to prevent low back pain in rural peoples.

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Difference in the practice of COVID-19 prevention according to the reliability of COVID-19 response among high school students in Korea (일부 고등학생들의 학교와 학원 코로나19 대응방역 신뢰도에 따른 코로나19 예방행동 실천의 차이)

  • Lee, Hocheol;Yoon, Hyejin;Kim, Ji Eon;Nam, Eun Woo
    • Journal of agricultural medicine and community health
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    • v.46 no.3
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    • pp.131-143
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    • 2021
  • Objectives: This study aimed 1) to investigate high school students' reliability on COVID-19 responses in schools and private academies and 2) to identify the differences in COVID-19 prevention practice. Methods: This cross-sectional survey collected data from 200 high school respondents, using an anonymous online questionnaire designed by the Yonsei Global Health Center, from July 2 to 17, 2020 in this study. Chi-square tests were conducted to analyze the differences in preventative practices and practice rates between schools and private academies. Binary logistics regression analysis was conducted to identify the factor affecting the reliability of COVID-19 response. Results: These high school students reliabilityed the schools' COVID-19 response more than the private academy. In addition, students who studied only at school did more COVID-19 prevention practices than students who studied both at school and academy. There was a significant difference in avoiding public transportation (p=.028), sitting in one row while having a meal (p=.011) in the practice rates depending on the schools' COVID-19 response. A significant difference in Covering the mouth when coughing and sneezing (p-.041) was also found in the practice rates depending on the private academies' COVID-19 response. Conclusion: The reason why schools were more reliable than private academies was that there are health teachers. Because schools are supervised by the ministry of education, the Ministry of education and local government need to work together to manage and monitor the COVID-19 response in the academies through cooperation between two organizations. In addition, it is necessary to arrange a temporary circulation health teacher who will provide the COVID-19 prevention education at the academies.

A Study on the Developmental Governance of Hyunpo Port (울릉도 현포항 개발 거버넌스 인식에 관한 연구)

  • Hwang, Yunwon;Song, Yongchan
    • Journal of Digital Convergence
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    • v.14 no.12
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    • pp.35-42
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    • 2016
  • This study investigated development method of governance of local residence, central and local government based on fishing ports as a new paradigm for restoration of sustainable space environment on Hyeonpo Harbor in Ulleung Island. According to the result of conducting a questionnaire survey on residents of Ulleung Island in order to carry out the research purposes, vulnerable living environment as poor accessibility and lack of hospital, community health center, and shopping district were pointed out as the biggest problem of residential environment in Ulleung Island of today. Secondly, there was a high recognition that development project on Ulleung Island of the government and local government is not actually contributing to the revitalization of regional economy and improvement in quality of life of Ulleung Island residents, and thirdly, lack of understanding on the importance or usage of various resources in Ulleung Island and insufficient support of the central government and local autonomous entity were pointed out as the bottleneck factors in implementation of the Ulleung Island development project. Fourthly, they perceived the current management level of Hyeonpo Harbor to be unsatisfactory. The results of this study demonstrated the importance of durability of development entities, vision of development of Hyeonpo Harbor, effort for the change of ownership mind, phased implementation considering reality of the area, and development that can provide small-scale profitable contents than a large theme.

Comparative Epidemiologic Survey of Measles in Two Primary Schools (2000년 영덕군 홍역 유행시 유행 차이에 따른 2개 초등학교 일부 학생에 대한 역학 조사)

  • Park, Sue-Kyung;Kim, Jee-Hee;Lee, Joo-Yeon;Na, Byoung-Kuk;Kim, Woo-Joo;Cheong, Hae-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.2
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    • pp.131-140
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    • 2001
  • Objectives : During March-May, 2000, a measles outbreak occurred at Youngduk, Korea. This county is divided into two areas with different historical and socioeconomic background. The outbreak occurred in one of these areas. We conducted a comparative epidemiologic study on the two areas in order to evaluate the factors related to the epidemic. Materials and Methods : We selected two groups, grades 3 and 5 in a primary schools in each area. We investigated outbreak-related factors using parent-questionnaires, the vaccination history from the student's health record and the records concerning the recent measles-outbreak from the local health center. Serologic test on measles-IgG and -IgM antibody was done. Results : The infection rate was 31.5% for the epidemic area and 3.7% for non-the epidemic area according to clinical or serological criteria (p<0.001). No difference was seen in the measles vaccination rate, residence at the time of vaccination or past measles infection history between the two areas. In the epidemic area, the attack rate for the 4-6 year-old MMR booster group(20.5%) was higher than the non-booster group(32.4%), but was not found significantly. Vaccine efficacy was 29.6% in the epidemic area and 87.0% in the non-epidemic area (p<0.001). The IgG level and positive rate were significantly different between the two areas (median 10727 IU/ml, 98.9% in epidemic area; median 346 IU/ml, 85.9% in the non-epidemic area, p<0.001). However, the IgG level and positive rate between the measles-cases and non-cases were not significantly different. Conclusions : This outbreak took place in mostly vaccinated children. These results suggest that a reduction of herd immunity for immunity failure after vaccination may be one of the feasible factors related to the outbreak pattern in the two areas. The results of the IgG level and positive rate suggest that re-establishment of a normal value for IgG level and of a qualitative method for IgG are needed.

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