• 보건행정학회지
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• 제3권1호
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• pp.124-145
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• 1993

General practitioners, internists, pediatricians, and family physicians are classified as so-called primary care physicians in the United States. We carried out this study for the purpose of answering the following question; "Who are the primary care physicians in Korea\ulcorner" We analyzed the 663, 154 claims which were drawn from the health insurance processing file made during the period of one month, April 1992 on the basis of systemic random sampling technique. The 663, 154 cases were matched with the doctor's file registered at the National Federation Medical Insurance by using the indivisual physician code number and analyzed according to the kind of specialty. If we follow the Geyman's definition of primary care physician in the United States, this study shows that they can take care of 43.2% of the total private clinic's claims in Korea. Provided that general practitioners and family physicians are considered the same way as in the United Kingdom, they could with only 8.3% of the total claims in Korea. The most frequent diseases are those which rank first to 46th in the total private clinic's claims. The proportion of the most frequent diseases was highest for pediatricians(90.4%) and followed by internists(81.4%), otolaryngologists(78.7%) and family physicians(76.5%). The proportion of the most frequent diseases in the most common 46 diseases was highest for radiologists(80.4%) and the next was as follows : general practitioners(78.3%), family physicians(67.4%), and internists(67.4%). We classified the most common 20 diseases of each specialty into 17 categories of ICD-9 and compared it with those of general practitioners. The specialists who had managed a similar disease pattern to those of general practitioners were identified as anesthesiologists, family physicians, general surgeons, and internists. Some specialists practicing at private clinics managed the diseases which were not quite appropriate for their specialties. After we evaluated each specialty by the most common diseases, the most frequent diseases, and the most frequent 20 diseases of each specialty in terms of the 17 categories of ICD-9, a tentative assumption is made that the primary physicians in the Republic of Korea are general practitioners, anesthesiologists, family physicians, internists, and general surgeons. This study has concluded that the categories of the primary care physicians are so diverse that their roles and distributions are distorted accordingly. Vigorous health policy efforts in correcting the malcomposition need to be made for the better provision of primary health care in Korea. in Korea.

• 한국농촌간호학회지
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• 제18권2호
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• pp.80-91
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• 2023

Purpose: The purpose of the study quantitatively investigates the experience of unmet healthcare service utilization by rural populations in vulnerable areas during the COVID-19 pandemic based on Andersen's behavior model. At the same time, this study attempts to describe the experiences of unmet healthcare service utilization among participants in vulnerable rural areas by analyzing qualitative contents through open-ended question. Methods: Data were collected from October to November 2022 using Qualtrix, a web-based survey platform. A total of 863 participants completed an online survey. Quantitative data were analyzed using 𝑥² test and logistic regression analysis. Qualitative data were analyzed using content analysis. Results: The factors affecting participants' unmet healthcare service utilization were type of residential area and underlying disease. The qualitative analysis identified; four categories and nine sub-categories. Conclusion: Based on these findings, it is necessary to develop a disaster nursing response model according to the type of residential areas and the number of people.

• 한국병원경영학회지
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• 제26권1호
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• pp.42-54
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• 2021

The purpose of this study is to analyze that ICT-based primary health care affects clinical changes of participants in the primary care chronic disease management pilot project using ICT medical care. Customized health information data, provided by National Health Insurance Service, was used for the analysis. The study targeted a total of 676 people that participated in primary care chronic disease management pilot project using ICT medical care from 2017 to 2018. Hierarchical regression was used to test three model. First, there were many subjects who used face-to-face consultation and non-face-to-face consultation(messaging), but less than half of patients using non-face-to-face consultation(telephone). Second, after participating in the pilot project, the fasting blood sugar level decreased. Third, the clinical condition of the subjects appeared to be an important factor in controlling blood sugar levels. Finally, patients using the non-face-to-face consultation(messaging) had reduced blood sugar levels after participating in the project. This results imply that non-face-to-face consultation is effective in reducing fasting blood sugar level with hospital intervention, and there are effects of the primary care chronic disease management project using ICT.

• 한국농촌간호학회지
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• 제4권1호
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• pp.41-50
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• 2009

By the rural area health care special law in 1980, Primary health care posts were established in rural areas as fundamental elements of the national health system. Nurses have been deployed to the posts after taking an education course mandated by the special law. However, health care posts have confronted environmental changes over the past 30 years such as an aging and decreasing rural population and advanced traffic systems, which make it necessary to reshape their form and role. Therefore, some guidelines are suggested for future role enlargement of health care posts by analyzing their current management and duties. The guidelines are as follows: 1) enlarging the portion of prevention and management of chronic degenerative diseases, 2) development and practice of diverse health promotion programs, 3) extension of primary health care for the increasing older population, 4) development of health programs for married immigrants, 5) practice of timely maternal child health programs, 6) development of adequate health care posts for low-income people in rapidly urbanizing rural areas and in poor areas in big cities, and 7) revision of laws and institutional arrangements for the role enlargement of health care posts to match social changes and customer needs.

• 한국융합학회논문지
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• 제5권3호
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• pp.7-16
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• 2014

본 연구는 노인 장기 요양 보험 등급자의 간호요구도와 주 수발자의 부양부담에 영향을 미치는 요인들을 파악하여 노인 장기 요양 보험 등급자를 위한 효율적인 간호중재를 개발하고 주 수발자의 부양부담감을 경감시키는 데 목적이 있다. J시에 거주하고 있는 노인장기요양보험 등급판정 받은자와 함께 거주하며 돌봄을 제공하는 주 수발자 152명을 대상으로 수집된 자료는 SPSS 17.0로 기술통계, t-test, ANOVA, 상관관계분석, 다중회귀분석을 실시하였으며 연구의 결과는 다음과 같다. 노인 장기 요양 보험 등급자의 간호요구도 중 심리사회적요구도가 가장 높았으며, 노인 장기 요양 보험 등급자의 일반적 특성 중 장기요양보험 수급유형과 장기요양 등급에 따라서는 신체적 간호요구와 심리적 간호요구도가 유의하게 나타났다. 주 수발자의 부양부담감 중 신체적 부양부담감이 가장 높았고, 노인 장기 요양 보험 등급자과의 관계가 배우자인 경우와 수입이 적고, 여자인 경우 부양부담감이 높은 것으로 나타났다. 부양부담감에 영향을 미치는 요인 중에서는 1일 간병시간이 가장 큰 영향을 미치는 요인임을 알 수 있었고, 특히 보험급여유형이 일반에 비해 기초생활수급자가, 주 수발자의 성별이 남자에 비해 여자가 부양부담감이 높았으며, 돌봄 제공자의 수가 많을수록 부양부담감은 감소하는 것으로 나타났다.

• Tuberculosis and Respiratory Diseases
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• 제57권6호
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• pp.594-598
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• 2004

원발성 반지세포 폐암종은 점액을 분비하는 독특한 선암의 일종으로 매우 드물게 발생한다. 예후가 불량하므로 타 원발성 및 전이성 폐암종과 감별이 필요하고 임상적인 검사로 원발병소를 찾기가 어려울 경우 조직면역학적 방법이 감별에 도움이 된다. 본 저자들은 다발전 골전이를 동반한 진행된 원발성 반지세포 폐암종의 증례를 문헌고찰과 함께 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10367-10374
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• 2015

Background: Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels. Aim: The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice. Materials and Methods: An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model. Results: Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model. Conclusions: The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.

• 한국농촌간호학회지
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• 제5권1호
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• pp.5-15
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• 2010

Purpose: This study was conducted to examine the effects of a self-control promotion program on self-efficacy, self-care and physiological indicators of patients with diabetes who live in local communities. Method: This research was designed using a nonequivalent control group pre, posttest study. Data were collected from December, 2008 through March, 2009. The participants of the study consisted of 93 patients with diabetes who live in a local community. A self-control promotion program was provided for the experimental group for 12 weeks. Data were collected through self-report questionnaires and direct measurements, and analyzed using descriptive statistics, $X^2$-test, and repeated measures ANOVA. Results: There were significant differences in self-efficacy and self-care between the experimental and control groups. However, there were no significant differences in physiological indicators such as fasting blood sugar, HbA1C, BMI, and BP between the two groups. Conclusion: The results indicate that the self-control promotion program was effective in promoting self-efficacy and self-care, which are crucial factors in controlling diabetes mellitus. However, a longitudinal study needs to be done to confirm the effects of self-control promotion programs on long-term glucose control.

• 한국농촌간호학회지
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• 제13권2호
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• pp.3-23
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• 2018

Purpose: This study was a descriptive study to investigate correlations between self-care behaviors and quality of hypertension management by hypertensive patients being cared by community health practitioners. Method: Participants were 583 people who were prescribed antihypertensive medications at a health clinic located in South Chungcheong Province. The survey was done from June 1 to July 30, 2018. A self-report questionnaire was administered, and data analysis was performed using descriptive statistics and Pearson correlation coefficients with the SPSS 24.0 program. Results: The rate of awareness, treatment, and control of hypertension were 97.9%, 99.1% and 92.8%, respectively. The number of hypertensive self-care behaviors was 1.82 (${\pm}0.36$) out of 3 points. The quality of hypertension management was 3.22 (${\pm}0.46$) out of 4 points. There was a moderate correlation between hypertensive self-care behaviors and quality of hypertension management (r=.340, p<.001). Conclusions: Results of this study confirm that the quality of hypertension management by community health practitioners is related to self-care behaviors of hypertensive patients. Therefore, it is necessary to improve the quality of hypertension management by health care specialists for self-management of hypertension patients. In addition, a systematic program to improve the quality of hypertension management by community health practitioner is needed.

• 보건교육건강증진학회지
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• 제33권4호
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• pp.67-77
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• 2016

Objectives: The study was to propose strategies and directions how to manage the hypertension and diabetes in communities. Methods: The survey data from 606 patients with hypertension or diabetes based on Community Health Survey, 2013 were analyzed and the hypertension and diabetes projects in communities for last 10 years were reviewed. Results: The patients visiting the primary clinics had statistically significant lower rates than those of teaching hospitals in physician's recommendation experience, perception level of attention from doctors, self-efficacy and health habit practice level. Since the Hypertension and diabetes registration and management system in 2007, there have been several trials for management of hypertension and diabetes such as Chronic diseases management system on the primary clinics, Community based primary medical care pilot projects, Post-national health screening management, and Pilot project on reimbursement for chronic diseases care services. Conclusions: The upmost urgent task might be to have a support system for patients' self care affiliated with primary clinics. To achieve it, it is necessary to expand the current Hypertension and diabetes registration and management system into nation and to find a way to attract the active participation from primary clinics.