• 대한예방한의학회지
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• 제17권2호
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• pp.69-78
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• 2013

Objectives : Health cooperative movement is of increasing concern among medical consumers and professionals in Korea. Most health cooperative clinics provide Western Medicine and Korean Medicine(KM) to patients. This study aimed to evaluate the primary care level of health cooperative KM clinics and compare it with local KM clinics in Korea. Methods : Face to face survey was performed at the 3 health cooperative KM clinics and 5 local KM clinics with the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of 5 domains (21 items): first contact (5), coordination function (3), comprehensiveness (4), family/community orientation (4), and personalized care (5). Subjects were patients or guardians who had visited KM clinics five times or more during the last 3 months. We compared primary care scores of each domain between health cooperative KM clinics and local KM clinics. Results : Data were collected from 200 respondents (100 patients from health cooperative KM clinics and 100 local KM clinics). Total average scores of the KPCAT for health cooperative clinics and local KM clinics were $81.1{\pm}12.0$ and $75.4{\pm}9.5$, respectively. Among primary care domains, personalized care was the highest ($89.2{\pm}12.0$, $89.6{\pm}8.4$, respectively), and comprehensiveness function was the lowest ($68.5{\pm}22.5$, $54.5{\pm}22.0$, respectively). Significant differences between two groups were noted in comprehensiveness function (68.5 vs. 54.5, P=0.000), family-community orientation (79.5 vs. 73.0, P=0.004), first contact(89.2 vs 84.0, p=0.001) and coordination function(74.0 vs 68.7, p=0.025). Conclusions : Based on the patients assessment, health cooperative KM clinics provide more primary care-oriented services than local KM clinics. This means that health cooperative clinic can be one of alternatives to strengthen the primary health care in Korea. Future researches are recommended to measure patients satisfaction and treatment effectiveness in the health cooperative clinics.

• 한국농촌간호학회지
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• 제12권2호
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• pp.45-54
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• 2017

Purpose: The purpose of this study was to provide a survey of patients with dementia registered and managed by primary health care posts. Method: Computation of 2016 dementia data registered in Health Care Center programs of 14 municipalities in ChoongNam province was analyzed. Data collection was done based on a pretest for dementia prevention and general management of registered dementia patients. Results: Results showed; Screening tests for dementia, 40% of population 60 or over, average number of cases, 174, average number of dementia registrants, 3.1, programs for prevention, approximately 70% special policy measures and 28% cognitive rehabilitation programs, counseling and education operating well overall, average number of dementia registrants/clinic 11.8, with women accounting for 70%, elders with less than 3 years of education, 75%, residence type cohabitation by married couples, 41%, and elders with Alzheimer type dementia, 64%. Conclusion: During early detection of dementia and follow-up examinations, high-risk groups (women, elders) should receive a dementia examination. In management of dementia there is a need to develop various programs including physical, economic, and emotional support not only for patients, but also for families. Health care managers also need systematic education to give them expert knowledge of dementia and management of dementia.

• 보건행정학회지
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• 제32권1호
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• pp.29-44
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• 2022

Background: This study was conducted to analyze the impact of having a usual source of care on health behaviors of the middle aged and the elderly, in order to investigate the potential effect of enhancing primary health care in a Korean context. Methods: This study constructed a balanced panel of middle-aged and elderly samples using the Korea Health Panel 2016-2018, and fixed-effect models were used to analyze the data. Results: Among three sets of dependent variables (physical activity, smoking, drinking), statistically significant results were found only in physical activity. Subgroup analysis showed that this effect was not observed in the late elderly (aged 75 and older) and those without chronic diseases. Conclusion: Results of the study implied that enhancing primary health care among middle age and the elderly may have an effect on improving health behaviors. Moving forward to person-centered primary health care from disease-focused primary health care should be considered in high-risk groups such as the middle aged and the elderly with chronic diseases.

• 한국농촌간호학회지
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• 제14권2호
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• pp.30-37
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• 2019

Purpose: This study was done to develop a comprehensive health promotion program based on the primary health care post, and then to examine the effectiveness of the program for rural elders. Methods: A single group pre-test post-test design was used, for 3 months and the 51 participants received the comprehensive health promotion program based on the primary health care post. Effectiveness of the intervention was measured immediately after the comprehensive health promotion program. Results: There were significant differences between pre-test and post-test on cognitive function (p=.001), depression (p=.001), systolic blood pressure (p=.001), blood sugar (p=.013), and cholesterol (p=.018). Conclusion: The comprehensive health promotion program based on the primary health care post was found to be effective for rural elders by improving cognitive function and physiological indicators and decreasing their depression.

• 한국농촌간호학회지
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• 제4권1호
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• pp.5-12
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• 2009

Purpose: The purpose of this study was to describe the prevalence of clonorchiais and analyze the knowledge level and intention of the participants to change their behavior related to clonorchiais. Method: The participants were 514 people from 7 community health posts along the Geum River. The formalin-esther sedimentation technique was used to detect the Clonorchis Sinensis (CS) eggs and a questionnaire for data on related factors. The study was carried on from December 2008 to January 2009. Results: The prevalence of CS averaged 9.3%, with a range from 0% to 24.6%. The significant factors were sex, habit of eating raw fish, and habit related to smoking and alcohol consumption. The level of knowledge was not high and not significantly different between the CS positive group and CS negative group. Intention to change their habits of eating raw fish showed various stages of change and attitudes to raw fish eating habit of others were not positive. Conclusions: These results suggest that a CS control program needs to be developed by community health services in the Geum River area to decrease the prevalence of clonorchiais.

• 보건행정학회지
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• 제3권2호
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• pp.100-129
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• 1993

This study is designed to find out some intra-clinic factors affecting the content of practice provided by primary care physicians in Korea, and proposed factors in this study are characteristcs of each private clinc --- physician-related variables(age, sex, specialty), bfed-related variables for inpatient care, laboratory-related variables for precise diagnosis. We have tried to estimate the difference of disease entities cared by each primary care physician according to above factors by analyzin gdisease data claimed during one month(April, 1992) to National Federation of Medical Insurance. The diagnosis codes by ICD-9 in the research disease data were reclassified to 'diagnosis clusters' by virtue of clinical similarities for effective analyses. We have converted frequent-tsing ICD-9 codes to 86 diagnosis clusters, which incorporated 97.4 percents of all ambulatory visits to private clinics. This result means proposed diagnosis-cluster method is effective tool for analysis of the content of ambulatory medical care carried out by primary care physicians. Comparisons and analyses of multiple diagnosis-clusters made on the basis of presented factors were done and the results were as follows; - Major factors affecting the difference between diagnosis-cluster pattern by each variables were phyusician's age, sex, specialty and bed counts of each private clinic for inpatient care and the size of laboratories of each clinic. - Middle aged(30th to 40th) group physicians are providing more comprehensive care than 20th or above 50th aged groups. Male physicians are more adequate for comprehensive care than female physicians, because woman-doctors are providing narrow-spectrum care. The content of practice of obstetricians and gynecologists shows much difference from primary medical practice, and they cannot be included in primary care physician, this study suggested. Pediatricians are also providing short-spectum acre, and nearly all visits to pediatricians were incorporated only 2-3 diagnosis-clusters. General surgeons' practices are very similar to general practioners' or family physicians' practices, the means they are providing primary care rather than special surgical care. And small number of beds(under 5 beds) and only basic(2-3 sorts of)diagnostic apparatuses are sufficient for primary physicians' clinic to carry out primary care. In conclusion, to reinforce primary care department in Korea, there must be support with health policy to expand office-based primary care practice-- with small number of beds for inpatient care and only basic laboratories-- provided by general practitioner of family physician.

• 한국농촌간호학회지
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• 제2권2호
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• pp.133-144
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• 2007

Purpose: The purpose of this study was to examine the trends of disease of residents who had treatment in primary health care posts in N-county over the past seven years (1997-2003). The data will assist in planning responses to changes in the health care environment and in planning health promotion programs. Method: A retrospective descriptive survey was conducted of the computerized records of primary health care done by community health practitioners over the last seven years. Cross analysis was conducted among the data using SAS, and the results were displayed in frequencies and percentages. The data were collected from May to September 2004. Results: The results of the study are as follows: 1. The six most frequent diseases were ranked as follows: diseases of the 1) respiratory system, 2) musculoskeletal system and connective tissue, 3) digestive system, 4) skin and subcutaneous tissue, 5) circulatory system, and 6) symptoms, signs and abnormal clinical and laboratory findings. Especially in 2002, circulatory system related disease rose two steps in the ranking and digestive system related disease went a step down. 2. The patients' use of primary health care posts over the past seven years continued to increase on the whole. Conclusions: According to these results, each primary health care post should carry out special health promotion programs that fit the local society of N- county and are in accordance with changes in health care needs.

• Journal of Preventive Medicine and Public Health
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• 제56권3호
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• pp.248-254
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• 2023

Objectives: Measuring the quality of care is paramount to inform policies for healthcare services. Nevertheless, little is known about the quality of primary care and acute care provided in Korea. This study investigated trends in the quality of primary care and acute care. Methods: Case-fatality rates and avoidable hospitalization rates were used as performance indicators to assess the quality of primary care and acute care. Admission data for the period 2008 to 2020 were extracted from the National Health Insurance Claims Database. Case-fatality rates and avoidable hospitalization rates were standardized by age and sex to adjust for patients' characteristics over time, and significant changes in the rates were identified by joinpoint regression. Results: The average annual percent change in age-/sex-standardized case-fatality rates for acute myocardial infarction was -2.3% (95% confidence interval, -4.6 to 0.0). For hemorrhagic and ischemic stroke, the age-/sex-standardized case-fatality rates were 21.8% and 5.9%, respectively in 2020; these rates decreased since 2008 (27.1 and 8.7%, respectively). The average annual percent change in age-/sex-standardized avoidable hospitalization rates ranged from -9.4% to -3.0%, with statistically significant changes between 2008 and 2020. In 2020, the avoidable hospitalization rates decreased considerably compared with the 2019 rate because of the coronavirus disease 2019 pandemic. Conclusions: The avoidable hospitalization rates and case-fatality rates decreased overall during the past decade, but they were relatively high compared with other countries. Strengthening primary care is an essential requirement to improve patient health outcomes in the rapidly aging Korean population.

• 한국농촌간호학회지
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• 제4권2호
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• pp.79-86
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• 2009

Purpose: This study was conducted to investigate the prevalence of Clonorchiasis and factors related to it among inhabitants of the area near the Sumjin River. Method: The data were collected from December 16, 2008 to January 10, 2009. Participants were 511 people who responded to a questionnaire. The formalinesther sedimentation technique was used to detect Clonorchiasis. The data were analyzed using descriptive statistics, $x^2$-test with the SPSS WIN 14.0 program. Results: The prevalence of Clonorchiasis by stool examination was 21.3%. There were statistically significant differences in prevalence of Clonorchiasis by gender ($x^2$=5.71, p=0.017), habit of eating raw fish ($x^2$=13.26, p<0.001), and alcohol consumption ($x^2$=10.54, p=0.032). The mean score for knowledge on Clonorchiasis was 10.68 (range 0-17) and there was no significant difference between the Clonorchiasis positive group and Clonorchiasis negative group. There were statistically significant differences in intention to change their habits of eating raw fish between Clonorchiasis positive group and Clonorchiasis negative group ($x^2$=26.10, p<0.001). Clonorchiasis positive group's intention was lower than the others. Conclusion: These results suggest that the prevalence of Clonorchiasis still high among the inhabitants in near the Sumjim River. Therefore, an effective management program for Clonorchiasis should be developed and administered.

• 보건행정학회지
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• 제24권1호
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• pp.100-106
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• 2014

Background: There is no consensus on the definition of primary care in South Korea. This study's objective was to define the concept of primary care using a Delphi method. Methods: Three expert panels were formed, consisting of 16 primary care policy researchers, 45 stakeholders, and 16 primary care physicians. Three rounds of voting, using 9-point appropriateness scales, were conducted. The first round involved rating the appropriateness of 20 previously established attributes of primary care. In the second round, panelists received a summary of the first-round results and were asked to once again vote on the 10 undetermined attributes and the provisional definition. The final round involved voting on the appropriateness of the revised definition. The Korean Language Society reviewed the revised definition. Results: Four core (first-contact care, comprehensiveness, coordination, and longitudinality) and three ancillary (personalized care, family and community context, and community base) attributes were selected. The Korean definition of primary care was accomplished with all three panel groups arriving at a 'very good' level of consensus. Conclusion: The Korean definition of primary care will provide a framework for evaluating performance of primary care in South Korea. It will also contribute to resolving confusion about the concept of primary care.