• 제목/요약/키워드: Primary Care

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치수절제술 시 고려해야 할 유구치 치근과 근관 (Consideration of primary molar's root and root canal for pulpectomy treatment)

  • 마연주
    • 대한치과의사협회지
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    • 제57권8호
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    • pp.474-479
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    • 2019
  • The purpose of the pulp treatment is to make the function of the primary molar in the oral cavity possible for as long as possible until the exfoliation of the tooth or the development of the occlusion is as long as possible. The pulpectomy is a relatively common procedure for the pediatric dentist in the clinic with dental care of the children nowadays. Primary molar is morphologically more susceptible to dental caries than permanent tooth, and the dental pulp treatment is frequently performed. Furthermore, unlike permanent teeth, the root canal has a large degree of curvature and morphological diversity and complexity, careful consideration is needed. Therefore, it is very important to comprehensively understand the morphological characteristics and diversity of the root and root canals for the successful pulp treatment of the primary molars.

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장기요양보호서비스의 비용분석 (Cost Analysis of Long Term Care Services)

  • 박창제;김수영;주수현
    • 한국노년학
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    • 제29권3호
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    • pp.1043-1061
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    • 2009
  • 본 연구의 목적은 현재 실시되고 있는 장기요양보호서비스에 대하여 유형별로 비용측면에서 경제성을 분석하고 정책적 함의를 논의하는 것이다. 조사대상자는 2008년 7월부터 시행되고 있는 노인장기요양제도의 적용대상자로 인정받은 65세 이상 노인과 그 부양가족이었고, 주부양자를 대상으로 요양보호서비스유형별로 구분하여 설문조사하였다. 회수된 설문지 중에서 방문요양 155부, 방문간호 67부, 요양시설 108부, 요양병원 92부 총 422부가 본 연구의 분석 표본으로 사용되었다. 조사결과 다음과 같은 사실을 확인할 수 있었다. 첫째, 부양 가계의 가계소득이 높지 않았다. 둘째, 장기요양보험제도가 실시되고 있음에도 불구하고 노인부양가계가 노인을 위하여 직접 지불하는 금액이 여전히 높은 편이다. 셋째, 부양가계가 노인을 위하여 수발하는 데 소요되는 간접비용이 아주 높은 편이다. 특히 재가서비스인 방문요양의 경우엔 평균 756,947원, 방문간호인 경우 594,807원으로 시설서비스에 비하여 간접비용이 상대적으로 아주 더 높았다. 넷째, 장기요양보호 노인에 대한 사회적 비용이 아주 높다. 이 금액은 본 조사에서 확인한 부양가계의 평균가계소득과 비슷한 수준이다. 다섯째, 요양보호서비스 유형별로 부양가계가 부담하는 서비스 비용에서 유의한 차이를 보였다. 여섯째, 부양가계의 직접 비용에서도 요양보호서비스 유형별로 유의한 차이를 보였지만 서비스이용비용보다는 그 차이가 작았다. 일곱째, 사회적 직접 비용은 요양보호서비스 유형별로 아주 유의한 차이를 보였다. 여덟째, 요양보호서비스를 이용하는 노인에 대한 사회적 비용금액이 아주 크고 서비스 유형별 총 사회적 비용이 전체 서비스 이용노인의 평균적인 사회적 비용에 수렴하는 경향을 보였다.

건강보험 40년 성과와 과제 (Achievements and Challenges of 40th Anniversary Health Insurance)

  • 이규식
    • 보건행정학회지
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    • 제27권2호
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    • pp.103-113
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    • 2017
  • There have been many achievements for 40 years since the introduction of compulsory health insurance. Despite many achievements, it has many challenges in health insurance. Aging, non-communicable disease, and low growth economy are threatening the sustainability of health insurance, and it is time to reform the health insurance. A long-term reform plan will be an absolute necessity for reform of health insurance and health care system. Health insurance and health care reform should be an extremely revolutionary content that completely changes the framework. This reform should deal with the philosophy of health, approach of medical education and doctor training, changing supply of medical service, the innovation of primary medical care, reform of public health system, the management of medical utilization, the integration of medical cure and care services, enhancing the benefit coverage, prohibition of covered and non-covered services, etc. Therefore, it is urgent to form a consensus on the necessity of reform, to establish the health insurance plan on this consensus, and to make efforts to make health insurance sustainable.

The Need for a Well-Organized, Video-Assisted Asthma Education Program at Korean Primary Care Clinics

  • Kim, Yee Hyung;Yoo, Kwang Ha;Yoo, Jee-Hong;Kim, Tae-Eun;Kim, Deog Kyeom;Park, Yong Bum;Rhee, Chin Kook;Kim, Tae-Hyung;Kim, Young Sam;Yoon, Hyoung Kyu;Um, Soo-Jung;Park, I-Nae;Ryu, Yon Ju;Jung, Jae-Woo;Hwang, Yong Il;Lee, Heung Bum;Lim, Sung-Chul;Jung, Sung Soo;Kim, Eun-Kyung;Kim, Woo Jin;Lee, Sung-Soon;Lee, Jaechun;Kim, Ki Uk;Kim, Hyun Kuk;Kim, Sang Ha;Park, Joo Hun;Shin, Kyeong Cheol;Choe, Kang Hyeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • 제80권2호
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    • pp.169-178
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    • 2017
  • Background: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. Methods: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). Results: The study enrolled 144 patients (mean age, $56.7{\pm}16.7years$). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from $16.6{\pm}4.6$ to $20.0{\pm}3.9$ (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). Conclusion: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.

한국인의 평생건강관리 프로그램 (Lifetime Health Maintenance Program for Korean)

  • 김영식
    • 한국건강관리협회지
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    • 제2권3호
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    • pp.97-116
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    • 2004
  • Lifetime Health Maintenance Program(LHMP) for Koreans is the Korean guide to clinical preventive services which include screening for chronic diseases, counseling and immunization. The Korean Task Force on the LHMP vigorously reviews evidence for interventions to prevent over 50 different illnesses and conditions which are important in Korea. The problems addressed in this program are common ones seen every day by primary care physicians in Korea: cardiovascular, infectious diseases, gastrointestinal and endocrine diseases, cancers, alcohol and smoking, and many others. Primary care clinicians have a key role in screening for many of these problems and immunizing against others. Of equal importance, however, is the clinician's role in counseling patients to change unhealthful behaviors related to diet, smoking, exercise, injuries, and sexually transmitted diseases. The recommendations are grouped by age, sex, and other risk factors.

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만성질환자의 상용치료원 보유 및 형태와 다빈도 응급실 이용 (The usual source of healthcare and frequent visits to emergency departments)

  • 한진옥;강경희;임준
    • 한국응급구조학회지
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    • 제21권3호
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    • pp.97-107
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    • 2017
  • Purpose: The purpose of the study was to investigate and compare the usual source of healthcare and frequent visits to emergency departments. Methods: The study subjects were 7,252 individuals with chronic diseases who filled out the questionnaire of the 2013 Korea Health Panel Survey. Data were analyzed using chi-square test and logistic regression. Results: Compared to having a public health center or clinic as a usual source of healthcare, it is 1.341 times more likely for a chronic disease patient to visit an emergency department if the hospital is her/his usual source of healthcare, while it is 1.656 times more likely for the patient to visit a general/tertiary hospital. Conclusion: It is important to investigate visits at the emergency department requiring primary care for diseases.

뇌졸중 환자를 돌보는 가족의 가족기능 영향요인 (Influencing Factors on Family Functioning of Caregivers in Families with Stroke Patients)

  • 유수정;박연환
    • 성인간호학회지
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    • 제18권3호
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    • pp.457-467
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    • 2006
  • Purpose: The purpose of this study was to identify the main factors influencing family functioning of caregivers in families with stroke. Method: A Convenient sample of 173 primary family caregivers who take care of a stroke patient at an Oriental medicine hospital in Jeonbuk. Interviews were done with a standardized questionnaire including family functioning by nurses. Results: In Pearson's correlation analysis, the influencing factors related to family functioning were ADL(p=.017), level of paralysis(p=.019) as stressors, Quality of relation(p=.000) as situational variables, and family caregivers' burden(p=.000). Stepwise multiple regression analysis showed 29.9% of the variance family functioning was significantly accounted for by the quality of relationship between stroke patient and caregiver(26.8%), and caregiver burden(3.1%). Conclusions: Findings indicate that families of stroke patients need family-focused nursing intervention as supported care to improve the relationship between patient and primary caregiver and relieve caregiver burden by culturally tailoring to Korean.

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한국인의 평생건강관리 프로그램 (Lifetime Health Maintennance Program for Korean)

  • 김영식
    • 한국건강관리협회지
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    • 제2권2호
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    • pp.231-245
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    • 2004
  • Lifetime Health Maintenance Program(LHMP) or Koreans is the Korean guide to clinical preventive services which include screening for chronic diseases, counseling and immunization. The Korean Task Force on the LHMP vigorously reviews evidence for interventions to prevent over 50 different illnesses and conditions which are important in Korea. The problems addressed in this program are common ones seen every day by primary care physicians in Korea: cardiovascular, infectious diseases, gastrointestinal and endocrine diseases, cancers, alcohol and smoking, and many others. Primary care clinicians have a key role in screening for many of these problems and imunizing against others Of equal importance, however, is the clinician's role in counseling patients to change unhealthful behaviors related to diet, smoking, exercise, injuries, and sexually transmitted diseases The recommendations are grouped by age, sex, and other risk factors.

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A Brief Screening Tool for PTSD: Validation of the Korean Version of the Primary Care PTSD Screen for DSM-5 (K-PC-PTSD-5)

  • Jung, Young-Eun;Kim, Daeho;Kim, Won-Hyoung;Roh, Daeyoung;Chae, Jeong-Ho;Park, Joo Eon
    • Journal of Korean Medical Science
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    • 제33권52호
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    • pp.338.1-338.5
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    • 2018
  • The purpose of this study was to develop and evaluate psychometrically the Korean version of the Primary Care Posttraumatic Stress Disorder Screen for the Diagnostic and Statistical Manual-fifth edition (K-PC-PTSD-5). In total, 252 participants were interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual-fifth edition-research version (SCID-5-RV). The K-PC-PTSD-5 showed good internal consistency (${\alpha}=0.872$), test-retest reliability (r = 0.89), and concurrent validity (r = 0.81). A score of 3 was identified as the threshold for clinically significant posttraumatic stress disorder (PTSD) symptoms. Overall, the results indicate that the K-PC-PTSD-5 is a useful, timesaving instrument for screening PTSD symptoms.

Practice-based Evidence for Health Promotion in Underserved Clients with Hypertension in Primary Health Care Settings

  • Hong, Woi-Hyun
    • 지역사회간호학회지
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    • 제26권4호
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    • pp.390-397
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    • 2015
  • Purpose: The purpose of this study was to explore practice-based evidence for health promotion in vulnerable populations with hypertension in primary health care settings. Methods: Two methodological procedures were adopted for this triangulation study. In the first phase, the sample was obtained from the computerized clinical data repository of a community nursing center. A total of 286 clients were assessed for hypertension as an actual circulation problem as coded in the Omaha System. In the second phase, a qualitative focus group was surveyed through semi-structured interviews conducted by nine advanced practice nurses who had been serving the hypertensive patients. Results: The community nurses provided essential primary healthcare services including health teaching guidance and counseling, and surveillance to vulnerable populations living in medically underserved community. There was a significant positive correlation between knowledge and behavior (r=.53, p<.01), between knowledge and health status (r=.40, p<.05), and between behavior and health status (r=.48, p<.01). Conclusion: This triangulation study encompassed not only quantitative findings from the computerized records of clients but also other information acquired from advanced practice nurses. This study contributes to understanding the importance of health promotion nursing interventions even with populations already diagnosed with chronic diseases such as hypertension.