The objective of this study is to investigate financial integrity strategies for sustainable development of local public medical centers, and particularly focus on seeking ways to enhance its financial efficiency and publicness. The data which was collected from 33 local public medical centers was analyzed by Data Envelopment Analysis to measure its financial efficiency. Then, Matrix Analysis was used to examine the association of financial efficiency and publicness of local public medical centers with related factors. In the aspects of facilities and location, according to the results, the local public medical centers which have larger number of available hospital beds or located in bigger cities were examined to have higher degree of publicness. In the aspect of human resources, greater number of doctors made both financial efficiency and the degree of publicness decreased, whereas higher participation rate of educational program for doctors affects increasing its financial efficiency and publicness. Lastly, in the aspect of costs, higher labor, material, and administrative cost diminished financial efficiency, but enhanced the degree of publicness. Based on these results, this study concluded that enhancing the publicness of local public medical centers should be pursued by increasing the accessibility with better facilities and location, and also concurrently organizing rational expenditure structure with appropriate cost investment to the resources of local public medical centers. Also, it is necessary to enhance both financial efficiency and publicness simultaneously by improving the quality of health care services through the educational programs for medical staffs.
The purpose of the study is to evaluate the community rehabilitation program of the two Public Health Center. Data were collected from the 138 clients who received rehabilitation services from visiting public health nurses. Data were analysed by SAS computer program. The result were as follows. 1. The clients have been average 7years disabled state until public health nurse visit them. 78.3% of them can't advance rehabilitation process because of insufficient family or social support. 2. The clients' burden due to their family's help was average 80.0 and that due to economic distresst was average 76.0. That factors were same that interfere rehabilitation process. 3. The clients needed exercise and modality therapy(78.2), economic support(76.0) and rehablitation advices (64.0). The needs of welfare benefit, medical service and social participation were 68.0, 61.5 and 54.5. 4. The pulblic health nurse visited the clients 2.3 time every month. And they have served emotional support (95.7%, exercise therapy (94.9%), family education(82.6%) and blood pressure management (71.7%), One client have received average 60% of the medical rehabilitation services and 27% of the refer services. 5. The rehabilitation effects of clients' attitude, knowledge and practice were 73.3, 81.0 and 68.7. The physical rehabilitation effect was 70.0. After receving rehabilitation services, the clients' preforrence to pulblic health center was 82.0. 6. The clients hopped that public health nurse visit them earlier (80.0). On the basis of this results, the following suggestions are proposed. 1. The pulblic health center is important institution in community rehabilition program, and every pulblic health center must participate in this program. 2. Various strateges have to be tryed and analysed to improve the visiting nurses' rehabilitation services. 3. For successful community rehabilitation, social welfare rehabilitation program must be developed and correlated with that of the pulblic helth center.
The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.
Objectives: The challenging issue of public health program is to strengthen partnership and network between health resources. This study identified the structure and characteristics of school health program network. Methods: In this paper we collected data from schools and organizations in 4 local communities in 2014 that participated to school health program. Using social network analysis techniques we measured the number of component, diameter, density, average degree, node centralization for each network. Results: We determined that networks shared some common organizational structure such as less density, low average degree, and short diameter. Networks were dominated by the health center, and directions of collaborations between nodes were mostly one-way. Conclusions: These findings can help to depict the network of school health program. The further research is necessary to define causal relationship between network effectiveness and public health outcomes.
A quasi-experimental study was conducted to develop a health education modification program based on self-efficacy and motivation regarding liver flukes and cholangiocarcinoma development in Keang Sanam Nang district, Nakhon Ratchasima province, Thailand. A total of 36 individuals were invited to participate in the program and were screened for population at risk of liver fluke infection and cholangiocarcinoma using SUT-OV-001 and SUT-CCA-001. Development of health education modification program regarding liver fluke and cholangiocarcinoma prevention included 3 steps: (1) preparation, (2) health education program, and (3) follow-up and evaluation. The study was implemented for 10 weeks. Pre-and-post-test knowledge was measured with questionnaires, Kuder-Richardson-20: KR-20 = 0.718,and Cronbach's Alpha Coefficient = 0.724 and 0.716 for percection and outcome expectation questionnaires. Paired and independent t-tests were applied for data analysis. The majority of the participants were female (55.6%), aged between ${\leq}50$ and 60 years old (36.1%), married (86.1%), education level of primary school (63.9%), agricultural occupation (80.6%), and income <4,000 Baht (44.4%). The results revealed that after the health education program, the experimental group had a mean score of knowledge, perception, and outcome expectation regarding liver fluke and cholangiocarcinoma prevention significantly higher than before participation and in the control group. In conclusion, this successful health education modification program for liver fluke and cholangiocarcinoma, therefore may useful for further work behavior modification in other epidemic areas.
The paper analyzes OECD health systems from the perspective of historical institutionalism. Criticizing the dependence of Korea's national health program on Pacific countries such as Japan and the U.S., it suggests that European experiences of national health programs can be a model of the Korean health system in the future. Based on an inquiry into Italian and British cases of national health systems, the author emphasizes (1) the role of local governemts in national health programs, and (2) the integration of a national health program with public health programs.
Oriental public health programs have been introduced for the purpose of providing comprehensive oriental health care services to community people including vulnerable classes, increasing the accessibility of oriental medicine and the public benefit, and further more elevating the health promotion and the quality of life of community people. Promoting these programs since 2002 in earnest, it is evaluated that it has made a lot of performances. In the other side, it showed many problems and policy issues also. This study is accomplished to analyze the problems made since the system was introduced and until now, 2007, and with this analysis, to examine policy issues and the reasonable recommendations for its development Major problems are as follows. First, fundamental notions and identity of oriental public health programs are not positioned accurately. Second, the infra-structure construction for effective propulsion of business is insufficient. Third, it is short of the capacity for program implementation of oriental public health doctors, related manpower, and health centers. Fourth, oriental health promotion programs that can fulfill the various health needs of community people are deficient. Fifth, active aid of the government and the oriental medical world as well as legal and systematical support for oriental public health programs is insufficient. As a result, to solve the problems and induce the successful settlement of the program, the policy recommendations such as (i) the fundamental notions of the program and establishment of approach strategies, (ii) reinforcement of the foundation of the program implementation, (iii) capacity enhancement of the manpower of the program implementation, and (iv) effective building of supportive system of the program are presented.
This study aimed to modify behavior regarding liver fluke and cholangiocarcinoma prevention in Chumphuang district, Nakhon Ratchasima province, Thailand through integrated learning. A total of 180 participants were included through purposive selection of high-risk scores on verbal screening. Participants attended the health education program which applied the health belief model included family based, knowledge station based, academic merit based and community based learning. Data were collected using a questionnaire composed of 4 parts: 1) personal information, 2) knowledge, 3) perceived susceptibility, severity, benefits, and barriers, 4) practice regarding liver fluke and cholangiocarcinoma prevention. The result revealed that the majority were female (79.9%), age ${\geq}60$ years old (33.2%), primary school educational level (76.1%), and agricultural occupation (70.1%). The mean scores of knowledge, perception, and practice to liver fluke and cholangiocarcinoma prevention, before participated the integrative learning were low, moderate, and low, respectively. Meanwhile, the mean score of knowledge, perceived susceptibility, severity, benefits, and barriers, and practice regarding liver fluke and cholangiocarcinoma prevention, were higher with statistical significance after participation in the integrated learning. This finding indicates that health education programs may successfully modify health behavior in the rural communities. Therefore they may useful for further work behavior modification in other epidemic areas.
With the growth of aging population in Korea, a better care of chronic and other degenerative illnesses is urgently needed. Evidences suggest that this can be achieved through incorporating a wide range of care options, expanding beyond medical interventions. The aim of this study is to analyze the distribution of publically funded research to understand if the Korean research and development funding system matches various approaches and purposes to successfully tackle the chronic care needs of an aging society. We complied the list of funded projects to be analyzed by searching the National Technical Information Service database with key words such as aging society/senescence, chronic diseases, disability, and health promotion. Most projects were based on the biomedical approach with the purpose of establishing the etiology and clinical (treatment) interventions. Health promotion projects showed a distinctive distribution with more percentage of projects based on psycho-behavioral approaches while research on chronic diseases predominantly biomedical. It would be necessary to diversify publically-funded research projects to develop effective and efficient care technologies for the future.
This is an underlying study for expanding child growth and developmental screening program, which had been implemented as a part of maternal child health service in a certain public health center located in P City. This study attempted to develop system model to discover, consult and follow-up developmental disabilities in children in early stage. For the purpose of providing groundwork for further development of screening program, the system model was analyzed and evaluated. One of the focuses of this study was developing practical tool that can aid small number staffs of public health center to handle large number of patients. 9 types of developmental checklist by key month was developed to support understaffed public health center. These checklists were also supplied to other public health centers, greatly improving qualitative and quantitative development of screening project. Also, the 4-step program of operating and managing child growth and developmental screening was proved to be quite effective. Total 632 children were evaluated and 21 of them were suspected to have developmental problem. Among these children, 8 children were determined to receive regular supervision of public health center. Other 13 children were recommended to visit professional institution, but only 7 of them actually visited institution. Four of these children who visited professional institution are currently receiving treatment, while the other 3 children were determined to require close observation. Five times of screening education were provided to the staffs in public health center and personnel in charge of children in every district public center in P City. The purpose of this training was to improve individuals' capability to implement project and to establish basis for expanding child growth and developmental screening program. The participants were guided to have continuous attention for the project, and their knowledge, skill and recognition were greatly improved through educational training. Also, professional child consulting and education, including lecture for baby food and baby food menu exhibition, were given to parents. Through this opportunity, parents acquired higher understanding about baby food while the local residents' recognition for maternal child health service was greatly improved.
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