• Title/Summary/Keyword: Primary Healthcare

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An Analysis of the Diseases Specific Medical Service Organization Selection Factors of Patients (주요 상병 별 환자의 의료기관 선택성향 분석)

  • Youn, Kyung-Il;Doh, Sei-Rok
    • Korea Journal of Hospital Management
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    • v.12 no.4
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    • pp.1-21
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    • 2007
  • The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

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Academic Medicine Is Patient-Centered Medicine (Academic Medicine은 환자 중심 의료이다)

  • An, Shinki
    • Korean Medical Education Review
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    • v.21 no.2
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    • pp.80-91
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    • 2019
  • The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.

A Study on the Improvement of Information Security Model for Precision Medicine Hospital Information System(P-HIS) (정밀의료 병원정보시스템(P-HIS) 정보보호모델 개선 방안에 관한 연구)

  • Dong-Won Kim
    • Convergence Security Journal
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    • v.23 no.1
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    • pp.79-87
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    • 2023
  • Precision Medicine, which utilizes personal health information, genetic information, clinical information, etc., is growing as the next-generation medical industry. In Korea, medical institutions and information communication companies have coll aborated to provide cloud-based Precision Medicine Hospital Information Systems (P-HIS) to about 90 primary medical ins titutions over the past five years, and plan to continue promoting and expanding it to primary and secondary medical insti tutions for the next four years. Precision medicine is directly related to human health and life, making information protecti on and healthcare information protection very important. Therefore, this paper analyzes the preliminary research on inform ation protection models that can be utilized in cloud-based Precision Medicine Hospital Information Systems and ultimately proposes research on ways to improve information protection in P-HIS.

Wound Care in an Older Rural Patient With Diabetic Lower Extremity Ulcers: A Case Report (당뇨병성 하지궤양을 가진 농촌 노인의 상처간호 사례보고)

  • Shin, Eun Ji;Park, Kyung Hee;Yi, Kyunghee
    • Journal of Korean Academy of Rural Health Nursing
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    • v.18 no.2
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    • pp.92-98
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    • 2023
  • Purpose: This study describes a case report of wound care performed by a community health practitioner for a rural older adult with diabetic ulcers. Methods: Data were collected from a rural older adult who had a diabetic lower extremity ulcer, and wound dressing was applied over 20 weeks after the skin graft operation. Results: The patient visited a primary healthcare post for regular ulcer care, and a community health practitioner applied appropriate wound dressings and managed the patient's diabetic condition. Conclusion: In rural areas, where healthcare resources are scarce compared with urban areas, rural nurses, such as community health practitioners, are primarily required to manage rural residents' health problems. Advanced nursing practices such as complicated wound care should also be appropriately provided to patients by enhancing rural nurses' competencies in the changing health care environment.

Current Status and Sustainable Development Strategies of Traditional Korean Medicine Official Development Assistance (ODA) in Global Health (국제보건에서 한의약 공적개발원조의 현재와 지속가능한 발전전략)

  • Yeeun Hwang;Seunghyeon Lee;Hyungwoo Kim;Hyoju Nam;Seungun Lee;Yousang Baik;Han Chae
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.257-270
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    • 2024
  • Objectives: Korea has a unique history of being both a recipient and a donor of Official Development Assistance (ODA), and the international community expects Korea to contribute to the development of developing countries by utilizing this experience. Traditional Korean medicine (TKM) seeks to contribute to global health, however the concept of ODA has been unclear and there has been no clear strategy and sustainable initiatives. Methods: This study examines the concept of ODA and its application in global health, including business objectives, scale, evaluation principles, and development strategies. Additionally, we reviewed the current status of Traditional Korean medicine globalization projects and conducted a SWOT analysis of the internal and external environment of the TKM sector. Based on these findings, we redefined the concept of ODA for TKM and proposed suggestions for its development. Results: The current study identified key ideas for TKM ODA. It should prioritize the improvement of primary healthcare in recipient countries, aligning with the international evaluation criteria of the SDGs. Secondly, TKM's 70 years of experience can be leveraged to enhance both the competence and economic benefits of recipient countries' medical systems. Based on these concepts, a TKM ODA development model was proposed, comprising two core visions, three development strategies and goals, and six core values. Conclusion: This study systematically examined the TKM in global health and suggested sustainable development strategies for TKM ODA. Through its expansion, TKM could contribute to the advancement of global traditional medicine and its overall engagement in healthcare.

Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States

  • Weiner, Joseph P.;Schwartz, David;Shao, Meng;Osborn, Virginia;Choi, Kwang;Schreiber, David
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.137-143
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    • 2017
  • Purpose: To analyze the utilization and fractionation of extreme hypofractionation via stereotactic body radiotherapy (SBRT) in the treatment of prostate cancer. Materials and Methods: Data was analyzed on men diagnosed with localized prostate cancer between 2004-2012 and treated with definitive-intent radiation therapy, as captured in the National Cancer Database. This database is a hospital-based registry that collects an estimated 70% of all diagnosed malignancies in the United States. Results: There were 299,186 patients identified, of which 4,962 (1.7%) were identified as receiving SBRT as primary treatment. Of those men, 2,082 had low risk disease (42.0%), 2,201 had intermediate risk disease (44.4%), and 679 had high risk disease (13.7%). The relative utilization of SBRT increased from 0.1% in 2004 to 4.0% in 2012. Initially SBRT was more commonly used in academic programs, though as time progressed there was a shift to favor an increased absolute number of men treated in the community setting. Delivery of five separate treatments was the most commonly utilized fractionation pattern, with 4,635 patients (91.3%) receiving this number of treatments. The most common dosing pattern was $725cGy{\times}5fractions$ (49.6%) followed by $700cGy{\times}5fractions$ (21.3%). Conclusions: Extreme hypofractionation via SBRT is slowly increasing acceptance. Currently $700-725cGy{\times}5fractions$ appears to be the most commonly employed scheme. As further long-term data regarding the safety and efficacy emerges, the relative utilization of this modality is expected to continue to increase.

A Systematic Review on the Vocational Pharmacy Education and Pharmacists' Role in the Singapore's Healthcare System (싱가포르 보건의료체계의 약사 양성교육과 약사 직능에 대한 체계적 고찰)

  • Kwon, Nu Ri;Cho, Eun
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.187-199
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    • 2015
  • Background: Singapore has the stable healthcare system with utilizing pharmacist manpower in proper positions by demand of populations' health among Asian countries. Objective: This study aims to systematically review (1) the pharmacists' role and (2) the pharmacy education system of Singapore in comparison with Korea. Method: We searched for information about academic, medical and governmental institutions related to professional pharmacists' practice in Singapore by primarily using database such as DBpia, KISS, Google Scholar and ProQuest and the official website of the Singapore Ministry of Health. We contacted and arranged the visit schedules with National University of Singapore, National Health Group's polyclinics, Agency for Integrated Care, National University Hospital, and community chain pharmacies. During onsite visits, we interviewed pharmacists working in each institution and obtained additional documents and materials relevant to this manuscript work. Results: To become a registered pharmacist in Singapore, the pharmacy curriculum requires four full-time academic years and six additional months allotted for pre-registration training. Pharm.D. course is offered for pharmacy graduate students with additional two full-time years of study. Team teaching and inter professional education program seem the most significant method in pharmacy education. Pharmacists working at hospitals, polyclinics, and community pharmacies in Singapore take broader roles and offer more cognitive services such as smoking cessation program and medication reconciliation. Especially, pharmacists in Agency for Integrated Care fill the role of primary care providers for the continuing care of the community through the governmental support toward the patients-centered integrated care. Conclusion: Singaporean pharmacists take significant and active roles in collaboration with other healthcare providers. Efforts such as interprofessional pharmacy education and governmental endorsement of the systematic and interactive care between pharmacists and other medical providers in Singapore are needed to be urgently applied to Korea healthcare system for the promotion of population health.

A Nation-Wide Epidemiological Study of Newly Diagnosed Primary Spine Tumor in the Adult Korean Population, 2009-2011

  • Sohn, Seil;Kim, Jinhee;Chung, Chun Kee;Lee, Na Rae;Sohn, Moon Jun;Kim, Sung Hwan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.195-204
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    • 2017
  • Objective : This 2009-2011 nation-wide study of adult Koreans was aimed to provide characteristics, medical utilization states, and survival rates for newly diagnosed patients with primary nonmalignant and malignant spine tumors. Methods : Data for patients with primary spine tumors were selected from the Korean Health Insurance Review and Assessment Service database. The data included their age, sex, health insurance type, co-morbidities, medical cost, and hospital stay duration. Hospital stay duration and medical costs per person occurring in one calendar year were used. In addition, survival rates of patients with primary malignant spine tumors were evaluated. Results : The incidence rate of a primary spine tumor increased with age, and the year of diagnosis ($p{\leq}0.0001$). Average annual medical costs ranged from 1627 USD (pelvis & sacrum & coccyx tumors) to 6601 USD (spinal cord tumor) for primary nonmalignant spine tumor and from 12137 USD (spinal meningomas) to 20825 USD (pelvis & sacrum & coccyx tumors) for a primary malignant spine tumor. Overall survival rates for those with a primary malignant spine tumor were 87.0%, 75.3%, and 70.6% at 3, 12, and 24 months, respectively. The Cox regression model results showed that male sex, medicare insurance were significantly positive factors affecting survival after a diagnosis of primary malignant spine tumor. Conclusion : Our study provides a detailed view of the characteristics, medical utilization states, and survival rates of patients newly diagnosed with primary spine tumors in Korea.

A Study on the Development of the Healing Environment Evaluation Criteria for Elderly Care Hospital focusing on the Elderly Inpatient Characteristics (노인환자의 특성을 고려한 노인요양병원 치유환경 평가지표)

  • Chun, Sookyung;Nam, Kyung-Sook
    • Korean Institute of Interior Design Journal
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    • v.26 no.4
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    • pp.22-29
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    • 2017
  • This paper investigates the evaluation criteria in order to manage healing environment of long-term care elderly hospital. Elderly hospital evaluation tool developed by Korean Government is used to assess elderly hospital facilities to check the hospital facility and maintain its quality. However, the evaluation indicators and questions mainly focusing on safety indicators. Some questions are too vague for precise evaluation. In this paper, we discuss the advantages and disadvantages of the present evaluation criteria to establish new assessment tool for precise evaluation. The literature research was conducted tp set up the new evaluation criteria. From this research, we developed an elderly focusing on healing environment checklist for elderly care hospital which contains 7 factors as the primary hierarchy structure (Safety, Accessibility, Amenity, Sensibility, Friendly to nature, Territory, Interaction) and 23 factors as the secondary hierarchy structure. This evaluation criteria will help healthcare facility designers and healthcare organizations to build the healthcare facilities.

Curriculum study of information security awareness for medical institution (의료기관 정보보호 인식교육을 위한 교육과정 연구)

  • Kim, Dong-Won;Han, Keun-Hee
    • Convergence Security Journal
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    • v.19 no.4
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    • pp.151-163
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    • 2019
  • As smart devices and communication technologies have developed rapidly, the healthcare industry in the globe is seeing remarkable issues on medical security. At the same time, personal medical records are being shared in the network, which would raise the risk of information security. This thesis aims to develop the curriculum to raise the awareness of information security among workers in medical institutions by referring to NCS(National Competency Standards) International standards, medical institutions' requirements and educational institutions' curriculums on information security based on proven results from medical devices and systems introduced in the public health centers, territorial branches, community health posts and primary, secondary, tertiary hospitals. Thus, this thesis offers the method to improve information security in healthcare institutions through validation testing conducted by medical practitioners and ICT experts.