• Korea journal of population studies
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• v.4 no.1
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• pp.23-35
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• 1981

Health policy is directed to equity in the provision of primary care for rural people before the year of 2, 000. This study aimed to define and identify the need for physician's care by using empirical data, and suggested an alternative of the primary care delivery system in rural areas to the government. 1. Twenty percent of the study population wanted to obtain any form of medical care services. : 9.3 percent of the population was in need for physician's care; 15 percent of the need was met by physicians, while 85 percent remained unmet at the time of survey in 1979. 2. For meeting all the need for physician's primary care, 2.9 annual physician visits per capita are demanded. An alternative, which was devised in some favourable way at reasonable cost in rural settings, was suggested. It was to deploy the physician extender such as community health practitioner in the infrastructure of the health care delivery system, whose supervision is provided by physician, based on experience of the KHDI health demonstration project. 3. One physician, two community health practitioners and two community health aides should be assigned in distant locations for meeting all the estimated need for physician's primary care for 10, 000 rural underserved residents.

• Journal of Preventive Medicine and Public Health
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• v.49 no.6
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• pp.343-348
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• 2016

Since noncommunicable diseases (NCDs) are generally controllable rather than curable, more emphasis is placed on prevention than on treatment. For the early detection of diseases, primary care physicians (PCPs), as well as general practitioners and family physicians, should interpret screening results accurately and provide screenees with appropriate information about prevention and treatment, including potential harms. The concept of quaternary prevention (QP), which was introduced by Jamoulle and Roland in 1995, has been applied to screening results. This article summarizes situations that PCPs encounter during screening tests according to the concept of QP, and suggests measures to face such situations. It is suggested that screening tests be customized to fit individual characteristics instead of being performed based on general guidelines. Since screening tests should not be carried out in some circumstances, further studies based on the concept of prevention levels proposed by Jamoulle and Roland are required for the development of strategies to prevent NCDs, including cancers. Thus, applying the concept of QP helps PCPs gain better insights into screening tests aimed at preventing NCDs and also helps improve the doctor-patient relationship by helping screenees understand medical uncertainties.

• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.271-273
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• 2015

Quaternary prevention should be implemented to minimize harm to patients because the ultimate goal of medicine is to prevent disease and promote health. Primary care physicians have a major responsibility in quaternary prevention, and the establishment of clinical epidemiology as a distinct field of study would create a role charged with minimizing patient harm arising from over-medicalization.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10565-10571
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• 2015

Gastric cancer incidence rates vary dramatically by world region with East Asia having the highest rate. The Asian population of the United States (US) is growing rapidly and over 17 million Americans are of Asian descent. A majority of Chinese, Korean and Vietnamese Americans are immigrants. Americans of East and Southeast Asian descent experience marked gastric cancer disparities and the incidence rate among Korean men in the US is over five times higher than the incidence rate among non-Hispanic white men. Randomized controlled trials have provided evidence for the effectiveness of helicobacter pylori identification and eradication in preventing gastric cancer. Additionally, Japan and South Korea have both experienced improvements in gastric cancer mortality following the implementation of programs to detect early stage gastric cancers. There are currently no clear US guidelines regarding the primary and secondary prevention of gastric cancer in high-risk immigrant populations. However, it is likely that a proportion of US physicians are already recommending gastric cancer screening for Asian patients and some Asian immigrants to the US may be completing screening for gastric cancer in their native countries. Surveys of US primary care physicians and Asian American communities should be conducted to assess current provider practices and patient uptake with respect to gastric cancer prevention and control. In the absence of clinical guidelines, US health care providers who serve high-risk Asian groups could consider a shared decision-making approach to helicobacter pylori identification and eradication, as well as gastric endoscopy.

• Journal of the Korean Society of School Health
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• v.1 no.1
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• pp.148-159
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• 1988

For the evaluation of physical assessment by school nurses, this study was designed in two steps physical assessment. The first step is the primary health screening by school health nurses. The second step is the Physicians' physical examination of ill health students selected by school nurses. This study was conducted on a total of 3,525 students of three primary schools located in urban, township, and rural area during the period from May to June, 1987, all data were collected through direct observation & survey method. The main findings are as follows 1. The number of ill health students selected by two step method was more than that of one step method by the physician. 2. The types of ill health students selected by two step method had more diversity than that of one step method by the physician. 3. Budgets and time consumption for two step method were more reductive than that of one step method by the physician.

• Health Policy and Management
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• v.19 no.3
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• pp.125-141
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• 2009

The purpose of this study was to examine the role of provider practice patterns in the difference in health expenditure between the two types of patients: Health Insurance and Medical Aid type 1. The study used the outpatient claim data for all Medicaid and health insurance patients of hypertension who received medical services from 8,454 primary care physicians during the first half of 2006. The data were stratified by patient's gender and age for the two groups of patients who received care from the same physician. The dependent variables were the differences in medical expenditure per case, patient days per case and medical expenditure per patient day between Medicaid patients and health insurance patients. Empirical results showed that physician characteristics, such as physicians under age 50, greater proportion of pediatric Medicaid patients, lower proportion of new Medicaid patients and the greater number of comorbidity of Medicaid patients are associated with the greater difference between the two types of patients (i.e., greater expenditure of Medicaid patients relative to health insurance patients). This study shows that factors associated with provider practice patterns need to be taken into account in Medicaid policy.

• Korean Journal of Health Education and Promotion
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• v.32 no.4
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• pp.59-65
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• 2015

Objectives: Health screening in Korea is very active in both the public and private sector. However, primary prevention for health promotion has not been activated yet. Quaternary prevention is the prevention of unnecessary medical interventions or the prevention of overmedicalization. Methods: Data was collected after a search of the literature focusing on keyword. The curriculum guidelines for family medicine residents were collected from the homepage of the American Academy of Family Physicians. Results: This quaternary prevention is just beginning. The first step to enhance the health promotion services in the community is to identify the barriers pertaining to the delivering of health promotion activities. These barriers are related to the patient, the physician, attitudes, health promotion programs and the healthcare system. The second step is to establish new changes, such as expansion of insurance coverage, improvement of medical payment system, provision of consumer-oriented services, connection and integration of providers, and the service provider education and training. Conclusions: In order to enhance the health promotion services in the community we need to identify the barriers and to establish several changes to overcome them.

• Korea Journal of Hospital Management
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• v.20 no.2
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• pp.15-27
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• 2015

As patient satisfaction is a crucial component of improved health care outcomes, there is a need to evaluate the relationship between physicians' attitude and patients' satisfaction. The objective of this study is to examine the relationship between patients' satisfaction and physicians' friendly and caring attitudes by using recent physician ratings by patients. Data from a cross-sectional survey using a convenience sampling was utilized to examine the relationship between physicians' attitudes and patients' satisfaction. The independent variable was the physician's attitude, and the dependent variables were patients' satisfaction with the physician and the office setting. A total of 273,994 patients it the US were included. The patients' average (standard deviation, SD) satisfaction with the physician was 78.08 (0.14), and the average (SD) satisfaction with the office setting was 78.62 (0.12) out of 100. Physicians' attitude was a significant predicting factor impacting the patients' satisfaction with the physician and the office setting (p < 0.001). To facilitate patients' satisfaction with healthcare, a continuous effort to develop physicians' ability to communicate in an empathetic manner should be undertaken so that patients perceive their physicians as empathetic.

• Journal of Korea Association of Health Promotion
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• v.2 no.3
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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.

• Journal of Korea Association of Health Promotion
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• v.2 no.2
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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.