Academic medicine is built from a foundation of education, research, and patient care. Since good patient care results from the application of medical research and continuous education, these three components cannot be separated for medical development to occur. In Korea, many obstacles hinder the achievement of academic medicine, such as an inefficient medical delivery system, limitations of primary care, low insurance prices, and no long-term health care plan. Medical education has changed to outcome-based education, but presented temporal integration status. Governance of healthcare research is not centralized, and Korea is awarded relatively fewer grants than other countries. Medical professors have reached a burnout state due to patient care responsibilities in addition to research and education duties. Many medical systems, including the medical delivery system and insurance problems, may contribute to distrust between doctors and patients. The government is not involved in a long-term health care policy. The multitude of factors mentioned here are hindering the achievement of academic medicine in Korea.
The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.
Care-stress among the dementia caregivers has been an important issue. The purpose of this study is to examine the effects of the dementia elderly's symptoms on the primary caregivers'care -stress. In addition, the moderators, the expert support and the family support, were used to examine the moderating effects between the symptoms and the care-stress. The data was obtained at 10 day-care facilities and services in Seoul, Gyeonggi and Busan province in South Korea. A total of 191 participants were analyzed. They were the spouses or the adult children of the dementia elderly who were diagnosed with dementia within five years. This study was conducted in multiple regression analysis. The main findings are as follows. First of all, the symptoms that the dementia elderly show were significantly associated with the primary caregivers' care-stress. Also, the interactive variable with the expert support was statistically significant. However, it was not significant with the family support. This means that only the expert support from doctors, nurses or social workers decreased the caregivers' care-stress. The implications of this study are 1) the necessities of the education that covers the specific symptoms of the dementia patients', 2) the extension of the supportive policies for caregivers' care-stress, 3) the necessities of more allocation of the dementia specialists in the practical settings and cooperative systems among the dementia specialists in various fields, and 4) the enhancement of the family function among families who have a dementia elderly as a family member.
Purpose: This study examined the definition of care coordination, and the activities and roles of nurse care coordinators. The study also proposed suggestions for establishing and expanding the role of nurse care coordinators in community health practice. Methods: This study derived its conclusions by conducting a literature review. Results: The definition of care coordination is a comprehensive concept that includes case management and transitional care, and can be summarized as organizer and integrator of care. According to the literature review, 12 activities and 6 roles of nurse care coordinator were identified such as a collaborator, an individualized care planer, an educator/counselor, a direct nursing care providers, a population care coordinator, and a program evaluator. Training for nurse care coordinators is currently addressed in the Primary Medical Chronic Disease Management Program. Visiting nurses working at the Eupyeong-dong visiting health and welfare service are expected to act as nurse care coordinators, and the role of nurse care coordinators will, in the future, gradually increase in various nursing facilities. Conclusion: In addition to developing competencies to act as a nurse care coordinator, there is need for approaches to health policy that develop both independent role and population focused role as care coordinators.
Journal of Family Resource Management and Policy Review
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v.25
no.3
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pp.103-120
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2021
Recently, the importance of the fathers role in the care of young children has been emphasized in Korea for the balance of childcare responsibilities between mothers and fathers. This study investigates the trends in paternal childcare in Korea over the last 15 years. Childcare is divided into primary and developmental care and fathers's Childcare time and participation rates are inverstigated for dual- and single-income households. Data are collected from the four waves of the five-yearly Statistics of Korea Life Time Surveys between 2004(t1) and 2019(t4) including the workday time diaries of fathers with preschool children(n1=2,264, n2=1,242, n3=959, n4=952). Three major results are identified. First, paternal childcare time and participation rates have increased with dual-income fathers spending 24 more minutes a day with their young child(ren) in 2019 than in 2004, which is nearly double. Second, in the analysis of fathers' childcare time use and participation rates comparing primary and developmental care, primary care is found to have increased more than developmental care, especially among dual income fathers: this further exhibits a reversed relation between primary and developmental care over time. Third, the determinants of paternal childcare time are fathers' age, market labor time, commuting time, gender equality consciousness, and education. In particular, market labor time was significant in all four waves, while gender equality consciousness is only significant for single-income fathers. Based on these results, a specific agenda is provided for family-friendly policies to improve the balance of childcare roles between fathers and mothers, especially encouraging increased(significant and sufficient) participation of fathers in primary care activities.
Demand for appropriate health care has gradually increased in Korea. In addition, developments of community- and school-based oral health programs have also focused oral health care for the oral health promotion. Especially, school-based oral health programs are the underpinnings of promoting oral health and preventing oral diseases among schoolchildren. School-based oral health programs have had three major components: oral health education, oral health services, and a healthful environments. These included oral health education(one-to-one communication, group communication, and use of mass communication), oral examination, fluoride mouthrinsing, pit-and-fissure sealants, fluoride gel application, mechanical plaque control, and chewing xylitol candy. In this study, we evaluate the effects of oral health programs among primary schoolchildren by comparing the oral health knowledge, oral health behaviors, and perception of caries prevention procedures. Data for this study were obtained from 699 primary schoolchildren at the two primary school in Daegu, Korea. One is experimental group, N primary school, that was established school-based oral health center under supervision of Nam-gu Public Health Center, the other is control group, N' primary school, that was yet to establish school-based oral health center. We surveyed children's oral health knowledge and behaviors, and perception of caries prevention procedures using self-administrated questionnaire and then analyzed differences of each item among two groups. The brief findings of this study were summarized as follows. There are several advantage to a comprehensive school-based oral health program. (1) School-based oral health programs facilitate and increase the effectiveness of teaching oral health subjects. (2) Schoolchildren are available for prevention or treatment procedure. (3) School-based oral health center may be less threating than private dental clinic. (4) With comprehensive school-based oral health programs the decayed, missing, and filled teeth(DMFT) of schoolchildren should demonstrate a substantial and steady decrease over time(Choi et al, 2004). In conclusion, treatment is not the answer to solving children's oral health programs; rather primary prevention is the key. Many countries and communities are focusing on hoe millions of underprivileged children can be provided with health care. Schoolchildren gain the knowledge and behaviors to attain and maintain good oral health in schools. For these reasons, the role of school-based oral health center is not only important but also a necessity.
The purpose of this study was to evaluate the effectiveness of oral health care including some of dental caries activity test on dental clinics of regular visiting on primary school children. The dental surveys and initial caries control and some of dental caries activity test (Alban's, Lactobacillius, S'mutans, un-stimulation saliva test)were performed by trained dental hygienists with dentist from on 6 to 13 years old patients of S dental hospital in Gwangju Metropolitan Cities. The sample size of 39 children (18 in oral health care group, 21 in control group ) and accepted to their parents. The results of caries activity test score(Alban's and Lactobacillius test)were reduced 1.4 to 1.6 times in oral health care group(OHCG). Oral Hygiene Simplified Index of OHCG was reduced 1.6 times during six months and 1 year. DMFT index of OHCG was reduced 1.4 times more than Control Group(CG) after 1 year. DT index of OHCG was reduced 12 times more than Control Group(CG) after 1 year. Dental health capacity of the first perment molar of OHCG was reduced 1.02 times more than CG after 1 year. From the above results, long life related incremental oral health care system has reinforced to primary school children in dental clinic with oral health professional teams.
In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis of functional capabilities; level I-primary or basic care, level II-secondary or specialty care, level III-tertially or subspecialty care. These facilities should be organized within a regionalized system of perinatal care. The transport system of newborn infants should be organized for referral of high risk newborn to centers with the personnel and resources needed for their degree of risk and severity of illness. In Korea, The korean society of neonatology was established and articulated in the 1994. During the past decade, the number of neonatologist has increased and neonatal intensive care units have proliferated in Korea. However, no standard definitions exist for the graded levels of complexity of care that neonatal intensive care units provide and no uniform guideline or recommendation for regionalization and referral system of high risk neonate have been established. With the rapid changing neonatal care system in Korea, the optimal neonatal care demands regionalization of care in utilization of manpower resources and in efficient use of advanced technology and facility.
The objective of this study were to examine the impact of medicaid coverage expansion policy aimed at improving access to primary care. The case-control study was conducted to compare preventable hospitalization(PH) rate in new medicaid recipients versus national health insurance(NHI) enrollees form 1996 to 2001. Rates of preventable hospitalization associated with ambulatory care sensitive conditions(ACSC) were calculated and standardized by age and sex. Multinomial logit regression model was used to control the confounding factors such as age, gender and charlson comorbidity index Annual PH rates in the new medicaid increased 1.64 times after medicaid expansion, with controling confounding factors. Meanwhile, annual PH rate in the NHI increased 1.68 times during the same period, with adjusting confounding factors. Current findings suggest that the new medicaid PH rate was less likely to rise than NHI PH rate after implementing medicaid expansion. This study is expected to provide policy-relevant evidence of medicaid expansion to include population with low income.
Kim, So Ri;Lee, Yong Chul;Sung, Myung Ju;Bae, Hye Won
Tuberculosis and Respiratory Diseases
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v.80
no.3
/
pp.221-225
/
2017
Since 2015, the Health Insurance Review and Assessment Service (HIRA) has performed annual qualitative assessments of asthma management provided by all medical institutions that care for asthma patients in Korea. According to the third report of qualitative assessment of asthma management in 2017, the assessment appears to have contributed to improving the quality of asthma care provided by medical institutions, especially primary clinics. However, there is still a gap between the ideal goals of asthma management and actual health care policies/regulations in real clinical settings, which leads to the state of standstill with respect to the quality of asthma management despite considerable efforts such as the qualitative assessment of asthma management by national agencies such as the HIRA. At this point, a harmonized approach is needed to raise the level of asthma management among several components including medical policies, efforts of academic associations such as education and distribution of the guideline for management, and reliable financial support by the government.
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