• Health Policy and Management
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• v.6 no.2
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• pp.58-90
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• 1996

This study provides an empirical analysis of location competition for demand maximization by central place theory among physicians in nonmetropolitan areas of Korea. The results show that the primary care physicians distribute themselves evenly from urban communities to rural communities. The subspecialists, however, cluster together in major cities rather than decentralize themselves in rural counties. This study establishes the three statistical models : Primary care physicians, subspecialist physicians, and total physicians. Two models of primary care physicians and total physicians have a strong significance in multiple regression analysis (p=-.0001). The primary care model explains approximately 45% of the variation and the total physicians model explains approximately 70% of the variation in physician/1,000 population ratios across national counties. The subspecialist physicians model analysze the tobit regreassion because of the left consored and truncated values(57 cases = 0). In all three models, analysis of the coefficiencts for physician centralization degrees in the 0- to 5- and 5- to 10-km rings around the core county reveals each a positive and negative association betwee these degrees and the physician/1,000 population ratios in the core county. Also, the results provide moderate evidence that the relationship between clinic physicians and community hospitals is competitive, and the relationship between clinic physicians and pharmaceutists is synergistic. This suggests that public policy makers and local self-governing bodies must take an active role to ensure procider availability and the regional health planning in all nonmetropolitan areas of Korea.

• Journal of Korean Academy of Rural Health Nursing
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• v.16 no.2
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• pp.45-53
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• 2021

Purpose: The study was conducted to identify the effectiveness of community health programs for local residents. Methods: This study was a one-group pretest-posttest study design. The subjects of the study were 259 residents in 26 villages of 13 primary health care posts located in G city. Data were collected using the questionnaire and analyzed using the paired t-test in SPSS 28.0. Results: As a result of performing the community health programs, prostate symptom scores improved in men, and stress and urgency urinary incontinence scores decreased in women. In addition, it was found that the degree of health-related knowledge increased among female subjects after the community health programs were provided. Conclusion: The community health programs were effective, and the effectiveness of the programs may differ according to gender. Therefore, when developing a program, it is necessary to consider a gender-sensitive approach that considers the difference between men and women.

• Health Policy and Management
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• v.28 no.3
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• pp.197-201
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• 2018

There is a general consensus that many health care problems are attributable to the structural defects of the health care delivery system in Korea. The basic policy aimed to address these problems is to reform the delivery system so as that it incorporates two core principles: (1) stratification of medical care institutions into primary, secondary, and tertiary care providers according to the capability to perform specialized and complex services; (2) patients seeking care starting from the primary care provider and, if necessary, to be referred to the other provider step by step. This policy has been consistently pursued for about 30 years, but the achievement is far from success. Thus it is believed that the feasibility of the policy should be questioned. Starting from this question, based upon the observation of the current structure of the delivery system and its expected changes, the reform policy was discussed focusing on the assessment of its feasibility from both practical and theoretical viewpoints. The discussion leads to cast doubt on the policy for its possibility of making planned changes and producing expected desirable effects. Therefore it is advisable to investigate a wide range of alternative strategies and models for improving health care delivery.

• Journal of Digital Convergence
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• v.10 no.10
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• pp.347-352
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• 2012

As medical treatment is developing with technology, the men's average life expectancy is extended. Therefore, primary medical care becomes emphasized in order to reduce the medical expenses in the long term by satisfying individual's life being healthy. The date for this thesis was collected from January 2011 to June 2011. 889 patients who visited the university hospital emergency room and hospitalized in internal medicine, were picked as the research subjects and they were targeted to be recorded the distribution of chief complaint and principal diagnosis of the patients. Also, this record was used to apply to the standard Classification of Diseases(as known as ICD) and the method of detailed classification of the primary medical care(as known as ICPC) to compare each other. In order to analysis, frequency analysis was used to see vital statistics and the cross tabulations were used to see the distribution of chief complaint according to ICD and ICPC. Results of the research were Abdominal pain(17.7%), Dyspnea(13.5%), Fever (12.5%), and Haematemesis (9.8%), and those symptoms represented the 54.5% of overall chief complaints that is treated in primary care. Therefore, it is acceptable to use the classification of the primary medical care at doc-in-a-box. Also, in case of diagnosis of abdominal pain, it is classified to R10 in ICD and 116 patients(18.7%) belonged to it, but according to ICPC, it is subdivided to Epigastric(11.5%) and General(5.8%). ICPC classification, which is focused to primary medical care is more detailed than ICD classification. Because the data that is collected for this thesis is from only one hospital, it is hard to represent to all the cases, but ICPC in emergency medical care, it has more classification available and it can subdivide the patients effectively, so it is meaningful.

• Journal of agricultural medicine and community health
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• v.14 no.1
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• pp.30-36
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• 1989

In order to desirable attitudes of health subcenter personnel, affecting to utilization of a rural health subcenter for primary health care, a study carried out, through analyzing the specific survey datas of 228 out of 1151 total house-holders in a rural community, Su-Dong Myun, Yam-yang-ju kun, Kyung-Gi Do in Korea, and the medical re-cords of total out-patients of health subcenter in this district during 1981-1988. The following results were obtained: 1) The annual utilization rate showed decreasing tedency such as 723 per 1,000 inhabitants in 1981, 652 in 1982, 618 in 1985, 54H in 1984 and 341 in 1987, since 1981. 2) The utilization Rate in 1987 was unusually the lowest with 341 per 1,000 inhabitants in decreasing tendency, steadily. 3) In advatage on utilization of health subcenter for primary health care in a rural area, 68.8% of the respondents answered that it was in comprehensive health care with the highest rate and next order in near distance from living place with 16.7% in easy and simple process to utilize with 9.2% and in lower medical cost with 5.3%. 4) The order of desirable image of rural health subcenter personnel for primary health care was of good attitude(57.0%), of good skill(29.0 %) and of wide knowledge(14.0%), 5) The order of desirable image of doctor for primary health care in rural health subcenter was of good skill(.44.3%), of good attitude(36.8%) and of wide knowledge(18.9%), and nurse was of good attitude(76.8%), of good skill(14.0 %) and of wide knowledge(9.2%). 6) The percentage order by good attitudes of rural health subcenter personnel was the highest in responsibility(38.2%), kindness(26.3% ), proprieties(14.9%), sincerity(12.7%) and notion of duty hours(6.6%). 7) The statistical datas in health subcenter was written and kept, without distinction of definition of new and old patients, by month and for suitable method of medical expenses of medical insurance and medicaid by clerical convenience. 8) In future, the organization of health subcenter must be unified, systematized and rationlized for primary health care. Health subcenter must be organized by 3 parts of function(medical care, health service and clerical affair) and then function of health subcenter will be more activated by clerical activities.

• Quality Improvement in Health Care
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• v.26 no.2
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• pp.86-94
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• 2020

Purpose: This study aimed to identify current quality control (QC) practices of primary care clinics participating in the National Cancer Screening Program (NCSP) in Korea. Methods: A nationwide survey using a structured questionnaire was conducted among the primary care clinics participating in the NCSP, which were selected by a proportionate stratified sampling. The questionnaire consisted of general information about the responding clinics and the scope of QC activities undertaken. A total of 360 clinics responded and the set of data was then analyzed with Chi-square test and multivariable logistic regression analysis. Results: Among 360 respondents, 332 (92%) reported that they were involved in the QC activities. Most frequently performed QC activities were 'maintenance of facility and instruments' (89%) and 'staff training' (85%). The analysis revealed, with statistical significance (p<.05), that there was an association between certain characteristics of the clinics and the scope of QC activities. These findings also indicated that the diversity of QC practices varies according to the size of the clinics. The clinics screening more types of cancer, those with more screenees, and those with more employees were more likely to implement various QC activities including 'maintenance of facility and instruments', 'external quality control', and 'management of screening data'. Conclusion: To our knowledge, this is the first study to investigate the current status of QC activities conducted among primary care clinics participating in the NCSP. The results of this survey can be used as a basis for further development of policies on quality management of small- and medium-sized primary care clinics in Korea. However, further studies encompassing various aspects of QC activities and management of primary care clinics are needed to assess the current situation in a concise manner.

• The Korean Journal of Pain
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• v.24 no.2
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• pp.112-114
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• 2011

Due to its complex pathophysiology and wide spectrum of clinical manifestations, the diagnosis of CRPS is often missed in the early stage by primary care physicians. After being treated by a primary care physician for 5 months for chronic cellulitis, a 16-year-old girl was referred to our hospital with features of type-1 CRPS of the right upper extremity. Inability to diagnose early caused prolonged suffering to the girl with all the consequence of CRPS. The patient responded well with marked functional recovery from multimodal therapy. Ability to distinguish CRPS from other pain conditions, referral for specialty care at the appropriate time and full awareness of this condition and its clinical features among various healthcare professionals are essential in reducing patient suffering and stopping its progression towards difficult-to-treat situations.

• Journal of Korean Public Health Nursing
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• v.13 no.1
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• pp.77-87
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• 1999

Poverty directly affects health and well-being, The poor population has a higher rate of chronics illness. higher infant morbidity and motality rates. shorter life expectancy. more complex health problems. and greater physical limitations resulting from chronic disease. In order to activate primary health care for the poverty in urban area the following measures should be taken : 1. Health center must be expended or establish subhealth center. 2. Health center must monitor neighbour's workplace's health management for their working population. 3. Health centers must do active home visiting nursing care for the urban-poor. 4. Health center must carry out flexible problem-centered practice according to the area. 5. For the urban-poor's health care must have organization of the health center & practice according to community's characteristics. 6. Public health care must be closely connected with welfare. 7. For the health care of the urban-poor must demand active community participation. 8. Health center is closely connected with Community hospital. 9. Active management of public health resource system is demanded.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8095-8099
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• 2014

Background: Worldwide, over half a million women died of breast cancer in 2011 alone. Mammography screening is associated with a reduction of 20 to 35% in breast cancer mortality. The aim of this study was to determine the awareness and practice of mammography screening and predictors of its uptake in Malaysian women attending a primary care clinic. Materials and Methods: A cross-sectional study was carried out among women aged 40 to 74 years attending a primary care clinic in Selangor, Malaysia. An assisted structured questionnaire included questions on socio-demography, source of information and level of knowledge. An adapted version of the revised Champion Health Belief Model Scale plus other associated factors for mammography screening up-take were also included as part of the questionnaire. Predictors for mammography screening uptake were only determined in those who were aware about mammography screening. Significant predictors were determined by logistic regression. Results: 447 women were recruited for this study; 99.1% of them (n: 411) were aware about breast cancer. Only 50.1% (n: 206) had knowledge about mammography screening. Prevalence of clinical breast-examination (CBE) was 23.3% (n: 104) and mammography screening up-take was 13.2% (n: 59). The predictors for the latter were those who have had clinical breast-examination (aOR=17.58, 95%CI: 7.68-39.82) and those aged between 50 to 59 years (aOR=3.94, 95%CI: 1.61-9.66) as well as those aged 60 years and above (aOR=6.91, 95%CI: 2.28-20.94). Good knowledge and positive beliefs about mammography screening were not associated with mammography screening uptake. Conclusions: Half of our Malaysian women were aware about mammography screening. However, the uptake of mammography was low. Previous CBE and older age were significant predictors of mammography screening uptake. Increasing CBE services may increase compliance with guidelines.

• Journal of agricultural medicine and community health
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• v.45 no.1
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• pp.1-12
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• 2020

Purpose: The purpose of this study was to examine the mediating effects of depression on relationship between sense of loss and suicidal ideation among Rural Elders use Primary Health Care Post's Services. Methods: This study was conducted using a descriptive survey design. Participants were 345 rural elders use Primary Health Care Post's Services in Jeollanam-do. Data were collected from August 1 to 31, 2017 using self-report questionnaires. Data were analyzed using descriptive statistics, Pearson's correlation coefficient, hierarchical regression and Sobel test with SPSS 21.0. Results: There were significant positive correlations between sense of loss, depression and suicidal ideation. It was found that physical loss is very high and significantly different only subjective health status on suicidal ideation. Also, Depression partially mediated the relationship between sense of loss and suicidal ideation of Rural Elders. Addtionally, The results show that depression plays a key role in suicidal ideation of Rural Elders. Conclusions: Based on the present findings, nursing interventions should be developed to decrease depression, with additional consideration towards sense of loss, specially physical loss, in order to prevent suicidal ideation among Rural Elders use Primary Health Care Post's Services.