• Title/Summary/Keyword: Rural society

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Recognition and Attitude to Implement at ion of Service Area Assigned System of Public Health Programs among the Health Officer (공공보건사업의 지역담당제 실시에 관한 보건기관 근무 공무원의 인식과 태도)

  • Kim, Mi-Soon;Lee, Moo-Sik;Kim, Nam-Song
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.15-41
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    • 2001
  • Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.

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Training, Working State and Ways of Improving Work of Sex Education Counselors in Health Centers (대구·경북지역 보건소 성교육 담당자의 훈련 및 업무현황과 개선방안)

  • Yeom, Seok-Hun;Kim, Chang-Yoon;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.159-175
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    • 2002
  • This present study was conducted to reduce problems by analyzing training and work of sex education counselors and to come up with ways of improving sex education counseling. A survey was performed in 57 subjects at health centers who finished training on sex education counseling in Taegu Metropolitan City and cities, kuns, and gus of Kyongsangbuk Province from December, 1999 to February, 2000 on general characteristics, items relating to the work of sex education, and ways of improving work. The results are as follows. Out of the sex education counselors, there were 55 females, taking 99% out of the total counselors, and the average age of these counselors was 42 years. There were 26 nurses, and their government grade was level 7 in 36 and level 6 in 14. The members who had finished sex education counseling at each public health center was 2.1 counselors at an average. Among those had finished sex education training, 30 was not in sex counseling. When analyzed the answers given by 27 sex counselors who were counseling at the time and the results are as follows. As for the amount of work, 15 answered to have too much work and 1 little; as for having pride on being a sex education counselor, 18 answered to felt pride and 7 so-so; as for materials for sex education and counseling, 25 answered to use videos, 23 books, 10 pictures, 8 beam projectors, and 7 slides. All of the subjects answered to have other responsibilities besides sex education and counseling, and the satisfaction felt on having other responsibilities was 6 satisfied, 12 average, and 2 dissatisfied. The proportion of work load in sex education counselors was other work besides sex education 76.2%, sex education at schools 7.6%. collecting sex education materials 5.7%, counseling of adolescents 4.9%. development of sex education materials 3.5%, and administrative work related to sex education 3.1%. The biggest problem of their work was over-load in 9 respondents, lack of sex education materials in 8, lack of training in 6, and shortage of professionals in 2. As for the answer on the ways of improving matters related to work of sex education counselors, the most frequent answer was that the organizations responsible for sex education needs to be more professional and systematic, followed by dividing the work load so that they could concentrate on developing education materials and sex education and counseling. Thus, the results of the present study indicated that in order to utilize human resources efficiently, the speciality of counselors needs to be considered when making personnel transfers among health centers, and continued activity as a sex education counselor needs to promoted by reducing other overloading tasks. And systematic re-training of the counselors needs to be done, and education manuals that are diverse and realistic to applicable to the children, who are to be the subjects of sex education, need to be developed and distributed.

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The Knowledge, Attitude, and Utilization Experience of Community Health Practitioners on Complementary Therapies (보완요법에 대한 보건진료원의 지식, 태도와 활용 경험)

  • Hwang, Sung-Ho;Park, Jae-Yong;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.87-105
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    • 2002
  • In order to find out the knowledge, attitude, and experience of community health practitioners(CHP) on complementary therapy, 393 community health practitioners who provide primary health care service in Busan, Kyeongnam, and Daegu, Gyeongbuk regions were interviewed or surveyed by mail from February 1st to March 31st, 2002. In terms of interest of CHPs toward 11 different hinds of complementary therapy, the rate of interest for soojichim was the highest with 75.3%. Aroma therapy had the interest of 71.0% of the CHPs, oriental medicine had 67.4%, and massage had 67.4%. The interest for shiatsu was 64.6%, while homeopath had the lowest rate of interest of 18.1%. In terms of reliance on the treatment results, oriental medicine scored the highest with 92.6%, and soojichim, massage, and shiatsu followed with 85.5%, 83.7%, and 81.7% respectively. Homeopath had the lowest reliance of 18.1%. The 65.1% of the CHPs had the experience of recommending oriental medicine to patients. 50.4% indicated that they had recommended soojichim, and 44.8% had recommended massage before. Shiatsu and aromatherapy followed with 34.4% and Homeopath had the lowest rate of 2.80%. When CHPs were asked if they had received any training in complementary therapy, 33.1% indicated that they had studied soojichim and 13.2%stated that they had learned oriental medicine. Aromatherapy, massage, and shiatsu followed with 11.2%, 8.4%, and 5.6% respectively On the other hand, none of the CHPs had received training in homeopath. In terms of using complementary therapy during the past 5 years, 23.9% had been treated with oriental medicine, and 18.896 had received soojichim. 5.9% had received aromatherapy, 5.3% had used massage, and 5.1% had experience with shiatsu. None of the practitioners had used homeopath during the past 5 years. Significantly many number of practitioners indicated that they had excellent treatment results with all hinds of complementary therapy, and there were rare cares of side effects. When they were asked if they wanted complementary therapy to become part of the curriculum during re-training or training for public service personnels, 78100 wanted soojichim, 69.2% wanted oriental medicine, and 67.9% wanted aroma therapy. 63.9% wanted shiatsu to be included, and 63.1% wanted massage. When CHPs were asked if they wanted to use complementary therapy during primary health care, 63.6% wanted to use soojichim, 52.9% wanted massage, and 51.9% wanted to use aroma therapy. Oriental medicine also showed a high rate of 50.1%. On the other hand, only a small percentage wanted to use chiropractic or homeopath with 17.0% and 12,2% respectively. Among the CHPs, there were some who had administered complementary therapy during the past 5 years. 84% had administered soojichim, 4.6% had administered oriental medicine, and 2.5% had administered massage 2.5% of the CHPs answered that they had administered aromatherapy. However, none of them had administered apitherapy or homeopath. Most of patients showed positive responses, and the rate of side effect was very low. As shown in the above results, although CHPs have a high rate of interest, reliance, and experience in recommending complementary therapy, only a low percentage of them had received any training in complementary therapy. In addition, since there were little side effects when they received or administered complementary therapy, they hoped complementary therapy, which can be beneficial to health, to be introduced to the curriculum. Therefore, in order to provide community members with complementary therapy and the correct information regarding the selection of complementary therapy that could be beneficial to health, a policy of continuous interest and support is needed so that CHPs can he provided with a systemic and rational curriculum of complementary therapy.

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The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center (의약분업 실시 전후 보건소 내소환자 진료내용 변화)

  • Chun, Jae-Kyung;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.75-86
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    • 2002
  • This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

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Comparison of Health Status and Activities for the Pain and No-pain Groups in the Elderly (노인의 만성동통 유무에 따른 건강상태 및 일상활동장애 비교)

  • Kim, Hyo-Jung;Kim, Myung-Ae;Park, Kyung-Min
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.79-89
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    • 1999
  • The purpose of this study is to compare health status and activities for the pain and no-pain groups in the elderly. The study subjects included 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes through interview using a closed-ended questionnaire from Nov. 6th. to Nov. 16th. 1997. The instrument used in the study was selected after carefully reviewing pain-related articles and records well described the characteristics of the elderly. The data were analysed by using descriptive statistics and chi-square tests. The findings were as follows : Of the 189 subjects, 83.6% reported experiencing the pain for the last year. By the age, there were significant differences between the pain and no-pain group(${\chi}^2$=9.572, p=.023). The percentage of the pain complainers was the highest in 80 years and older(100.0%), followed by 70~74(89.1%), 75~79(81.3%), 65~69(76.8%) which presented crude increase according to age. By sex, men had lower pain prevalence(69.5%) than that of women(90.0%). The number of pain complainers was higher in women than men(${\chi}^2$=12.448, p=.023). There were significant differences between the pain and no-pain groups by spouse distribution(${\chi}^2$=10.736, p=.001), educational state(${\chi}^2$=13.020, p=.000), occupation(${\chi}^2$=18.807, p=.000). Pain prevalence in the subjects having no spouse(59.3%) was higher than those having spouse(40.7%), Illiteracy rate was higher in pain group(49.0%) than no-pain group(13.3%). The number of the subjects having occupation(full time or part time) was fewer in pain group than no-pain group. By health status, there were significant differences between two groups(${\chi}^2$=40.055, p=.000). : the pain group showed poor(61.4%), followed by moderate(22.1%), good(16.5%) while no-pain group showed good(64.5%), moderate(29.0%), poor(6.5%). By activities, there were significant differences between the pain and no-pain groups. The pain group was disturbed more severely than the no-pain group in movement(${\chi}^2$=57.829, p=.000), sleep(${\chi}^2$=12.785, p=.000), usual activities(${\chi}^2$=39.196, p=.000), receiving guests(${\chi}^2$=13.163, p=.000), and hobbies and recreation(${\chi}^2$=28.177, p=.000).

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The Physical and Social Disability of Aged Persons Who Live Alone in Goksung Area (곡성지역(谷城地域) 독거노인(獨居老人)의 신체적(身體的) 사회적(社會的) 능력장애(能力障碍)에 관(關)한 조사(調査))

  • Kim, Shin-Woel;Kim, Young-Lak;Ryu, So-Yeon;Park, Jong;Kim, Ki-Soon;Kim, Yang-Ok
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.245-268
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    • 1999
  • It is necessary that the old should have the physical and social ability to perform their daily life. This study is to grasp their degree of disability and problems and suggest their solutions. It surveyed the 87 old people over 65 years old from September 1st until September 30th, in 1997. The findings are as follows. 1) The activities of daily living(ADL) to find their degree of physical disability shows that their average performance ability is 75.9% of all the action while 24.1% of all the old people needs the others' help. As they get older and older, the aged drop off in their physical ability, which is related to a statistical sense (p<0.001). 2) The social disability shows that the aged have their great difference from 9.2% to 85.1% in their instrumental activities of daily living(IADL), intellectual ability and social role. 3) A simple analysis shows that the activities of daily living are, in a statistical sense, related to age(p<0.001), the use of elder's hall(p<0.001), the understanding degree of health(p<0.01) and so forth. 4) A simple analysis shows that the instrumental activities of daily living are, in a statistical sense, related to age(p<0.001), the degree of education(p<0.05), the life of leisure(p<0.001), the understanding degree of health and so forth. 5) A multivariate logistic regression analysis shows that the disability of daily living is related to age, the visit of elder's hall, the period of solitary living, instrumental activities of daily living is age and the visit of elder's hall, and social role is the visit of elder's hall and the decree of education, while intellectual activity has no related variables in a statistical sense.

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Factors Related to Serum Level of Carbohydrate Antigen 19-9 and Cancer Antigen 125 in Healthy Rural Populations in Korea (일부 농촌지역 주민에서 혈청 CA19-9 및 CA125 농도에 영향을 미치는 인자에 관한 연구)

  • Lee, SK;Yoo, KY;Park, SK;Kang, DH;Kim, JQ;Chung, JK;Lee, MC
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.71-80
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    • 1998
  • This study examines the levels of carbohydrate antigen 19-9(CA19-9) and cancer antigen 125(CA125) in serum and its related factors in healthy Korean population. Although CA19-9 and CA125 have been widely used tumor markers for gastroenteric cancers and ovarian cancer in Western countries, there are no information available on the serum levels of CA19-9 and CA125 in healthy population and the factors affecting the levels of these tumor markers in Korea. A cross-sectional study was performed to measure CA19-9 and CA125 among 76 healthy males and 95 healthy females in Korea. CA19-9 and CA125 were quantitated using solid-phase radioimmunoassay kits. Informations on the factors which might be related to the levels of these markers were collected by questionnaire(e.g., smoking, alcohol consumption, menstruation, oral pill use, breast-feeding history, etc.). There was no statistically significant difference in the mean of CA19-9 concentration between men(10.4 u/ml) and women(10.1 u/ml), whereas the mean of CA125 levels(11.2 u/ml) was higher in women than that(2.5 u/ml) in men. Although there was a statistically significant association between CA19-9 and average number of cigarette consumed per day(r=0.59, p=0.026) and total number of cigarettes consumed in women(r=0.74, p=0.003), the significance disappeared by multiple regression analysis after adjusting age and body mass index. Later age of menopause(p=0.035) and longer duration of breast-feeding(p=0.050) were significant predictors for CA125 levels in women by multiple regression analysis after adjusting age and body mass index. In conclusion, CA19-9 can be used as a stable tumor marker in clinical practices, however, menstruation and breast-feeding should be considered when CA125 is used in women.

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Epidemiological Studies of Clonorchiasis - II. Current Status and Natural Transition of the Endemicity of Clonorchis sinensis in Goyang Gun, a Low Endemic Area in Korea (간흡충증(肝吸虫症) 역학(疫學) - II. 저도유행지(低度流行地) 고양지방(高陽地方)에 있어서의 간흡충감염(肝吸虫感染)의 현황(現況)과 자연추이(自然推移))

  • Kim, D.C.;Lee, O.Y.;Lee, J.S.;Ahn, J.S.;Chang, Y.M.;Son, S.C.;See, S.H.
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.66-80
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    • 1983
  • As a part of the epidemiological studies of clonorchiasis in Korea, this study was conducted to evaluate the current endemicity and the natural transition of the Clonorchis infection in Goyang Gun a low endemic area in recent years, prior to the introduction of praziquantel which will eventually influence to the status of the prevalence. The data obtained in this study in 1983 were evaluated for natural transition of the infection in comparison with those obtained 16 years ago in 1967 by the author (Kim, 1974). The areas of investigation, villages and schools surveyed, methods and techniques used in this study were the same as in 1967, except for the contents of the questionnaire for raw freshwater fish consumption by the local inhabitants. 1) The current prevalence rate of Clonorchis infection among the inhabitants was 7.5% on the average out of a total of 479 persons examined. The prevalence rate was 9.0% in the riverside area and 4.2% in the inland area. Among the schoolchildren, the prevalence rate was 1.1% out of a total of 1 319 examined. By area, it was 1.4% in the riverside area and 0.7% in the inland area. By sex, the prevalence rate was 13.3% in the male and 1.3% in the female in the inhabitants and no difference was seen in the schoolchildren. 2) In the natural transition of the infection, the prevalence rate in the inhabitants has decreased from 22.5% in 1967 to 7.5% in 1983, and in the schoolchildren, from 9.5% in 1967 to 1.1% in 1983. The reduction rate was higher in the riverside area than in the inland area. 3) In the prevalence rate by age, 1.2% was seen in the 10-14 age group and gradually increased to 8.1% in the 30-39 age group and reached peak 18.1% in the 40-49 age group. By sex, in the male, the prevalence rates have increased to 31.9% and 33.3% in the 40-49 and 50-59 age groups, respectively and decreased thereafter. In the female, the prevalence rate less than 5% was seen only in between the 10-14 and 30-39 age groups. 4) In the natural transition of the prevalence rate by age, sharp decrease was seen in the male from around 50% in 1967 between 15-19 and 30-39 age groups. The generation over 40s showed less decrease. In the female, the prevalence rate has decreased from 13% in 1967 to 5% in 1983 in the middle age groups and dropped to 0% in the rest of the age groups. 5) The intensity of the infection among clonorchiasis cases by mean EPmg (number of eggs per mg feces) value was 1.4. In the inhabitants, the value was 2.0 in the riverside area and 0.4 in the inland area. While in the schoolchildren, the value was 0.2 in both riverside and inland areas. 6) In the transition of the intensity of the infection, EPmg among the inhabitants has decreased from 3.9 in 1967 to 2.0 in 1983 in the riverside area, and from 2.9 to 0.4 in the inland area. In the schoolchildren, the reduction was similar in both riverside and inland areas resulting from 1.0-1.1 in 1967 to 0.2 in 1983. 7) In the intensity of the infection by age, EPmg 3.4 was peak at the 40-49 age group and 0.2-1.0 was seen in the rest of the age groups. The mean value was 1.5 in the male and 0.6 in the female. 8) In the natural transition of the intensity of the infection, the EPmg has decreased from 2.7 in 1967 to 1.4 in 1983. By age, reduction was seen in all of the age groups, particularly in the young and the old age groups of 50s and over, except in the 40-49 age group in which reverse phenomenon was seen. By sex, it has decreased from 3.5 in 1967 to 1.5 in 1983 in the male and from 1.0 to 0.6 in the female. 9) In the distribution of the clonorchiasis cases by the range of EPmg value, 70.3% of the cases were placed in the range of 0.1-0.9 as the most and 16.2% in 1.0-4.9 as the next. With such figures, those included in the range less than 0.9 as light infection were 78.4% and under 5.0-9.9 up to moderate infection 99.3% of the cases were covered. The cases were distributed up to 20.0-39.9 in the male and to 1.0-4.9 in the female. 10) In the transition of the distribution of the clonorchiasis cases by EPmg, the highest intensity reached up to 60.0-79.9 in 1967 and to 20.0-39.9 in 1983. In the range of light infection, under 0.1-0.9, the distribution in rate was 64.5% in 1967 and 78.4% in 1983. Up to the range of moderate infection, under 5.0-9.9, 91.7% in 1967 and 97.3% in 1983 were seen respectively. 11) In a survey for raw freshwater fish consumption among the local inhabitants,78.3 of the clonorchiasis cases interviewed admitted their experience of the raw consumption. However, those who practised in the past two years were 34.8% 55.6% of those who have such experience in the past professed that they did not practise raw freshwater fish consumption in the past two years. 12) The major cause of the reduction of the raw freshwater fish consumption among the inhabitants were the wide spread water pollution in the locality. The most common reason professed for stopping raw freshwater fish consumption among the inhabitants was the risk of the fluke infection. 13) In animal survey, 3.1% of dogs were found infected with Clonorchis, decreasing from 21.6% in 1967. 14) The distribution of the first intermediate host, Parafossarulus manchouricus has greatly diminished in this locality and found only in two localized ponds. No Clonorchis infection was found from the snails examined. 15) The second intermediate freshwater fish host has been further limited by extended water pollution. No susceptible fish host could be examined. 16) In conclusion, the endemicity of Clonorchis infection in Croyang Gun, low endemic area, has significantly decreased during the past 16 years. The major cause of the regressive transition of the infection was the water pollution of the freshwater system of this locality. This has upset the ecosystems of the intermediate host of Clonorchis sinensis in many areas of waterbodies and further discouraged to a significant extent the local inhabitants from raw freshwater fish consumption.

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Health Status and Use of Health Care Services of the Elderly Utilizing Senior citizen Centers (경로당 노인의 건강상태와 건강관리서비스 이용 관련요인 분석)

  • Shin, Sun-Hye;Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.99-113
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    • 2002
  • For this study a sample of 205 people, 66 males and 139 females, over 65 years of age, residing in C-gu of S-si and utilizing senior centers, were selected, The objective of the study was to provide basic data for health promotion program development provided by health centers. A questionnaire was used to collect date on general characteristics, health status, social health status and utilization rate for health services. The instruments used in this study were the Lawton scale, to measure daily routine function, the MMSE-K developed by Folstein and modified to fit the Korea situation, for mental health status, and the CES-Dtool developed by Radloff, for emotional health status. the SPSS Window program was used to calculate percentages. Tests of significance were done using t-test and ANOVA. Multiple regression analysis was used to identify variables influencing the use of health services. The results are as follows : Of those utilizing senior citizen centers, 40.9% of males and 17.3% of the female thought they were healthy. The average score for IADL was 7.4. The daily routine of female respondents consisted of buying household articles and drugs, and other IADLs such as riding the bus or subway alone. These resulted in a higher score compared to males. For emotional health, 7.6% of the males reported depression compared to 21.6% of the females. For mental health, 48.5% of the males and 28.8% of the females were found to be in the group suspicious for dementia. On social health, 57.6% of the males and 62.6% of the females reported no intimate human relations. Of those older people who had close human relations, 52.5% of the males indicated a friend as the closest person and 53.8% of the females, their children. On use of health services, there was a significantly higher need for mobile medical care services treatment for those with lower education levels and status of window/widower. There was a significantly higher need for health exmination services for those with lower levels of exercise, greater satisfaction with sleep, higher levels of oral health care, and higher social contacts. In conclusion, there is a need to provide varied programs for the promotion of health, along with parallel resolution of social, psychological and economic issues. It is recommended that health services for elderly people provided by the health centers be implemented with full recognition of these characteristics and differences.

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Performance State and Improvement Countermeasure of Primary Health Care Posts (보건진료소(保健診療所)와 업무실태(業務實態)와 개선방안(改善方案))

  • Park, Young-Hee;Kam, Sin;Han, Chang-Hyun;Cha, Byung-Jun;Kim, Tae-Woong;Gie, Jung-Aie;Kim, Byong-Guk
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.353-377
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    • 2000
  • This study was performed to investigate the performance state and improvement countermeasure of Primary Health care Posts(PHPs). The operation reports of PHPs(1996 330 PHPs, 1999 313 PHPs) located in Kyongsangbuk-Do and data collected by self-administered questionnaire survey of 280 community health practitioners(CHPs) were analyzed. The major results were as follows: Population per PHP in 1999 decreased in number compared with 1996. But population of the aged increased in number. The performance status of PHP in 1999 increased compared with 1996. A hundred forty one community health practitioners(50.4%) replied that the fiscal standing of PHP was good. Only 1.4% replied that the fiscal standing of PHP was difficult. For the degree of satisfaction in affairs, overall of community health practitioners felt proud. The degree of cooperation between PHP and public health institutions was high and the degree of cooperation of between PHP and private medical institutions was high. The degree of cooperation between PHP and Health Center was significantly different by age of CHP, the service period of CHP, and CHP's service period at present PHP. Over seventy percent of CHPs replied that they had cooperative relationship with operation council, village health workers, community organization. CHPs who drew up the paper on PHP's health activity plan were 96.4 % and only 11.4% of CHPs participated drawing up the report on the second community health plan. CHPs who grasped the blood pressure and smoking status of residents over 70% were 88.2%, 63.9% respectively and the grasp rate of blood pressure fur residents were significantly different according to age and educational level of CHP. CHPs received job education in addition continuous job education arid participated on research program in last 3 years were 27.5%, respectively. CHPs performed the return health program for residents in last 3years were 65.4%. Over 95% of CHPs replied that PHPs might be necessary and 53.9% of CHPs replied that the role of PHPs should be increased. CHPS indicated that major reasons of FHPs lockout were lack of understanding for PHP and administrative convenience, CHPs were officials in special government service governors intention of self-governing body. CHPs suggested number of population in health need such as the aged and patients with chronic disease, opinion of residents, population size, traffic situation and network in order as evaluation criteria for PHP and suggested results of health performance, degree of relationship with residents, results of medical examination anti treatment, ability for administration and affairs in order as evaluation criteria for CHP. CHPs replied that the important countermeasures for PHPs under standard were affairs improvement of PHPs and shifting of location to health weakness area in city. Over 50% of CHPs indicated that the most important thing for improvement of PHPs was affairs adjustment of CLIP. And CHPs suggested that health programs carried out in priority at PHP were management of diabetes mellitus and hypertention. home visiting health care, health care for the aged. The Affairs of BLIP should be adjusted to satisfy community health need and health programs such as management of diabetes mellitus and hypertention, home visiting health care, health care for the aged should be activated in order that PHPs become organization reflecting value system of primary health care.

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