• Title/Summary/Keyword: Long-term Care Services

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Beginnings of the Community Health Practitioner (CHP) System in Republic of Korea (한국 보건진료원 제도의 시작)

  • Yi, Ggod-Me
    • Journal of Korean Academy of Rural Health Nursing
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    • v.4 no.1
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    • pp.31-40
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    • 2009
  • Purpose: This research was done do identify and analyze the beginnings of the community health practitioner system in the Republic of Korea (ROK) around 1980. Method: Primary sources were collected and analyzed, mainly newspapers around 1980, the act for health service for rural areas, and other relative publications. Results: The government of the ROK was trying to solve the problem of doctorless villages and regarded the introduction of primary health care (PHC) services using registered nurses (RNs) to be an economic solution to this problem. The Korean Nurses' Association presented 'a plan for community health service' to the government party and medical association in 1976. In this plan, RNs would provide primary care at the sub-county (myun) level, and hospital would provide secondary care. The Korean Public Health Development Research Center was awarded the project 'RNs and nurse aids as CHP for primary care service and their training'. In 1977, 25 RNs began to work as PHC in 3 areas, and interim findings showed that RNs were very capable of doing PHC. The Ministry of Health and Welfare announced long term plans for health and welfare administration including a tertiary health care delivery system. RNs after training were posted to rural areas with no medical services to do medical treatment for mild cases. The Act for health services for rural areas was enacted on December 31, 1980. Enforcement Ordinance and Enforcement Regulations were enacted in 1981. In 1981, 257 CHP were selected, trained, and deployed. In 1983, the president of the ROK announced continuation of the CHP system for residents of medically vulnerable areas. The number of CHP increased from 257 in 1981 to 2038 in 1989.

A Study on the Allocation Planning of Community Based Elderly Welfare Facilities - Focused on Urban Area - (일상생활권을 고려한 지역밀착형 노인복지시설의 배치계획에 관한 연구 -도시지역을 중심으로-)

  • Jeon, Sung-Min;Kwon, Soonjung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.15 no.4
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    • pp.33-43
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    • 2009
  • As a result of rapid aging speed in our society, many problems related to elderly people have happened in many parts of our society. Among them, supply for elderly housing is one of the biggest problems. To solve these problems, 'long-term care insurance' has been put in operation from July 2008. By the time of the insurance operation, Ministry of Health and Welfare is increasing facilities every year according to '10-year expending plan of Care service infra' from 2002. As a result, the supply rate of elderly facilities has been raised. But the differences of facility supply rate between regions are very high in some cases. Therefore older people who need care sometimes cannot get proper care services in some areas. In that case, the frail older people have to use other care facilities of other regions. This is not a proper situation from the point of "Aging in Place". In order to prevent that case, it is necessary to set up proper 'Daily Living Spheres' and establish elderly care plan for it. Considering the points above, this study proposes the size of 'Daily Living Spheres' for the elderly, the kind and amount of elderly care facilities in it for the construction of Community Based Elderly Care System.

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Artificial Neural Network Analysis for Prediction of Community Care Design Research in Spatial and Environmental Areas in Korea

  • Yumi, Jang;Jiyoung An;Jinkyung Paik
    • International Journal of Advanced Culture Technology
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    • v.11 no.2
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    • pp.249-255
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    • 2023
  • This study aims to empirically confirm the effect and impact of community care design research centered on domestic space and environment on health promotion, diagnosis treatment, disease management, rehabilitation, and mitigation through the year of publication and perspective. To this end, based on 1,227 space and environment design studies from 2,144 community care design research data conducted for about 20 years from 2002 to 2022, when care services began in earnest through the long-term care system for the elderly, SPSS 26.0 was used to create a 'Multi-layer Perceptron' artificial neural network structure model was predicted and neural network analysis was performed. Research Results First, as a result of checking studies in each field of health care by year, there is a significant difference with the number of studies related to health promotion being the highest. Second, the five perspectives are region, time, dimension, function, and content perspective. As a result of inputting these variables as independent variables and analyzing their importance in the artificial neural network, the function perspective had the most influence, followed by the region > content > dimension > time perspective.

A Study on Reforming the Occupational Health Care System is Korea (산업보건서비스체계의 효율적 관리방안에 관한 연구)

  • 문옥륜;한동운;최병순;최재욱;하은희;이기효;장동민
    • Health Policy and Management
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    • v.4 no.1
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    • pp.138-175
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    • 1994
  • The objectives of this study are (i) to review current situations and problems of the occupational health care system with emphasis on reforming the organizations and services, (ii) to find out a disirable occupational health system model based on integration of the occupational health system and the general health system, and finally, (iii) to suggest policy implications in occupational health services in the light of objectives of the newly emerging national health insurance reform in Korea. The major policy implications of this study are as follows: 1. In the long-run, within the occupational health system, preventive occupational health services such as employees' physical check-up, working environment examination, etc should financially be integrated with industrial accident compensation insurance. Currently separately paying expenses for each different category of services by the owner of an enterprise should be disbursed once through the payment of contributions of industrial accident compensation insurance. And then, it is necessary to strengthen and expand the role and function of industrial accident compensation insurance to cover preventive occupational health services. 2. The occupational health system should be integrated with general health system for its effective management. For the short-term policy, it is necessary to eliminate fiscal and access barrier between industrial accident compensation insurance and national health insurance by means of ex post facto settlement of accounts. The duplication of employees' physical check- ups between under the health insurance program and under the industrial health services must be coordinated in a manner either through mutual authorization by the two parties concerned or through merge into the health insurance. 3. The intent of current employees' physical check-up system focused on detection of occupational diseases, should be converted to an idea of medical surveillance system or biological moritoring system. The introduction of medical surveillance or biological monitoring system is a necessary condition to build a positive, effective and inexpensive occupational health care system.

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Factors affecting family Caregivers' Preference for Utilization of Community Eldercare Services (가족부양자의 재가복지서비스 이용의사에 영향을 미치는 요인에 관한 연구)

  • Song, Da-Young
    • Korean Journal of Social Welfare
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    • v.53
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    • pp.105-128
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    • 2003
  • This study examined the factors affecting family caregiver's preference for utilization of community care services among those who are caring for 65+ elderly parents, and aimed to show how social eldercare services would be settled in Korea. Help-seeking behavior model developed by Anderson and Newman(1973) was used to analyze the factors affecting their preference for utilizing the community care service among 283 family caregivers. Frequency, Chi-square, and Multinominal logistic analysis on SAS 6.12 was used. According to the results, about 90% of the family caregivers have preference for community and institute care services. In community care service, about a half comprise the preference with charge while the other without charge. However, about 90% of those for institute care service show their willingness to pay for the service. Also, a majority of caregivers like to rely on social eldercare service, rather than family as exclusively responsible, against long-term care for their elderly parents. Multinominal analysis demonstrates that use versus nonuse of community care services is primarily affected by predisposing factors(including age, carer-caree closeness, and familism) and need factors (including economic or psychological burden of eldercare, and additional role for family care). Enabling factors, such as family income level, economic support from other family members and siblings, and supportive care-helpers, are mainly associated with the preferences of free versus charge in service use. These findings provide some implications and suggestions for the development of social eldercare services in our aging society.

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A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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Determination of Nursing Price using Willingness to Pay (지불용의접근법을 이용한 간호서비스의 가격결정)

  • Ko, Su-Kyoung;Park, Jeong-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.205-221
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    • 2001
  • It will become more and more popular to use the long-term care facilities and home health care services with the chronic disease increasing. It depends on how much the consumers would pay and purchase the services. They might get more benefits from that kind of services than from ordinary hospitalization. So far, the study of determining the medical service price has focused most often on the efforts from the providers' view. But it must be reasonable to include the consumers' value for the service. This study was performed to assess WTP(Willingness to Pay) for home health care service in order to apply to the determination of nursing price in a reasonable manner. In this study, respondents were asked if they would pay for the service's intangible benefits under the four different types(open-ended minimum WTP, open-ended maximum WTP, bidding WTP, referendum WTP). The contingent valuation method is a potentially useful tool in understanding how people value the benefits of the service. As a result, average open-ended minimum WTP was W16,015 per day among 65 respondents. Average open-ended maximum WTP was W29,154 per day among 65 respondents. Average bidding WTP was W26,300 per day among 65 respondents. Average referendum WTP was W22,200 per day among 70 respondents. The results of regression analyses were also consistent with theoretical prediction, e.g., increasing WTP with consumers' value for the service, state of patients, and household income. This study demonstrated that it was more reasonable to consider the consumers' value in determining the services' price. In addition, a further study is needed to test the validity of this CV method and to determine a proper nursing price based on the consumers' view.

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Analysis of Maternal Child Health Services in Korea - Perspective of the Premature Infant - (우리나라 모자보건 정책사업 분석 - 미숙아와 저체중출생아를 중심으로 -)

  • Lee, Hye-Jung;Lee, Kwang-Ok;Shin, Mi-Kyung
    • Child Health Nursing Research
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    • v.15 no.1
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    • pp.81-87
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    • 2009
  • In recent years, reductions in infant mortality have mainly been accomplished by improving the survival of premature and low birth weight infants, however premature infants still remain at great risk. The purpose of this study was to review the maternal child health service related to premature infants and to provide a future direction for improving maternal child health (MCH) in Korea. We reviewed two MCH services which are directly related to premature infants: 1) a registry and financial support program for families with a premature infant, and 2) financial support to build neonatal intensive care units in rural public hospitals. Suggestions are made for the development of a national vital signs record system to identify high risk infants and to monitor the trends in infant mortality due to prematurity. Prevention efforts and preconception care for childbearing women is also an important strategy to reduce the rate of preterm births. Finally, we need consider long-term follow-up plans for premature infants for a successful transit to the special education system. Developing MCH policy related to premature infants that decreases the occurrence of premature may decrease infant mortality, and also improve maternal and child health services.

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The Effect of Publicness on the Service Quality in Long-Term Care Facilities (공공성이 노인장기요양시설의 서비스 질에 미치는 효과)

  • Kwon, Hyunjung;Hong, Kyungzoon
    • Korean Journal of Social Welfare
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    • v.67 no.3
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    • pp.253-280
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    • 2015
  • This study reconsiders the concept of publicness by raising a question about the problems which the recent marketization of social services in South Korea. The existing perspective on publicness, however, is insufficient to account for the entire Long-term care market because only public organizations have publicness. Accordingly, this study presents 'integrated publicness', particularly 'dimensional publicness' and 'normative publicness'. A disproportional stratified sampling procedure was used to consider ownership. A merged dataset combining surveys from 248 Long-term Care facilities and on-line resources was used and analyzed by multiple regression, negative binomial regression and multiple imputation analysis. The analysis results suggest as follows. First, ownership publicness appeared more effective in the overall. Second, the regulations on the government funding did not show effective, and the regulation on evaluation system showed the effect. Third, professionalization of normative publicness showed a negative effect on service structure and showed a positive effect on service process. Lastly, user of free services whose public accountability was identified to be effective on service structure and outcome. These findings suggest that not only existing ownership but also dimensional publicness and normative publicness showed an effect on service quality. In this respect, this is important as the performance produced by empirical models of integrated publicness, in this situation that the outcome of marketization is insignificant.

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Data Mapping of the Terms for Developing an Integrated Information System in Home and Visiting Healthcare Documents (재가.방문 건강관리 통합정보시스템 구축을 위한 관련 서식지 항목 매핑 연구)

  • Kim, Jeong-Eun;Park, Sung-Ae;Yoon, Soon-Nyoung;Lee, In-Sook;Park, Hyeon-Ae;Kim, Jin-Hyun;Lee, Kyung-Soon
    • Perspectives in Nursing Science
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    • v.8 no.1
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    • pp.32-41
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    • 2011
  • Purpose: This study sought to determine the possibility of developing the data-sharing infrastructure of an integrated information system to improve the quality of home and visit-based healthcare services. Methods: The articles of study here were the forms used by a visiting healthcare agency, a home healthcare system of a home healthcare agency, and those used in long-term care insurance for elderly. We visited a visit-based healthcare agency and a home healthcare agency to survey their forms and interviewed relevant practitioners, and we searched for forms associated with long-term care insurance for the elderly on the Internet. We then organized the terms in each form and mapped them among the form after analyzing the concepts as a whole to inquiry into the possibility of integration. Results: The mapping procedure divided the terms into those related to personal information, problems and interventions. Mapping between the standard system (Omaha system) and the type of form was also done. Conclusion: In this study, we found that programs were configured differently depending on the objectives of the service. It is necessary to develop the program with an integrated information system by comparing the three services in terms of their distinct advantages, after which such a service should be utilized. The results of this study can serve as a database for the creation of a new integrated system.

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