Journal of agricultural medicine and community health
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v.17
no.1
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pp.25-33
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1992
Most of oriental medical care resources such as doctors and facilities are distributed in urban areas and approximately ten percent of them is in rural areas. However the aged population of over 60 years old in rural areas is higher than that in urban and these aged population prefer more oriental medical care than the other age group. Therefore, the government planned to carry out the oriental medical care demonstration project in a designated rural areas in 1990. The study was carried out to find out the utilization pattern of medical care and consumers attitude toward oriental medical care treatment provided by health centers. The interview survey was applied to collect the data and 187 patients, who visited to health centers to receive care in 1991, were selected by random sampling. The study results obtained were as follows : 1) Among the 187 respondents, male was 31.6% and female, 68.4%. 2) 73.8% of the respondents were the age of over 45 years old. 3) For the motivation of visiting the health center to receive oriental medical care, 37.4% of the respondents visited purposely according to announcement of oriental medical care and 26.2% of them made a decision by themself 20.3% of them was recommended by the neighbors. 4) The most frequent symptoms surveyed were the disease of the musculoskeletal system and connective tissue. 5) By the subjective judgement of the respondents from the result of the oriental medical treatment, recovered or improved cases represent 69.5%. It is considered that the oriental medical care was acceptable, and also the respondents were satisfied with the oriental medical care in terms of kindness of oriental medical doctors, treatment time and expenses of care.
Purpose: This study examined: 1) what it meant for patients to have multimorbidity 2) how they manage their illness using health care facilities, and 3) what contextual backgrounds exist regarding the health care system. Methods: This qualitative research obtained individual in-depth interviews from 22 patients. Participants were selected by purposive sampling among those who saw physicians more often than the national average from the 2013 medical-claim data. The transcribed data were analyzed using Ground theory. Results: Multimorbidity patients suffered from "chain-like serial symptoms" and "pain without a breakthrough". They expressed themselves as "indeed patients among patients", "my body is a general hospital", and "an incompletely normal person". There was a demand to resolve the anxiety arising from the situation in which the body keeps getting sicker without showing any signs of recovery. In a state of reduced social support and a lack of trust in the doctor, their desire to be healed led them to receive a temporary relief through dependence on medical institutions. Conclusion: This research recognized the desire of multimorbidity patients to seek temporary relief through dependence on medical institutions. A more patient-centered directed care plan, specific to the needs of the patients with multimorbidity is required.
Kim, Jung-Hee;Park, Jin-Sook;Joo, Chan-Uhng;Choi, Ki-Chul
Quality Improvement in Health Care
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v.4
no.1
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pp.116-124
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1997
Background : As parking problem caused by increasing owner-driver and patients concentrating to a general hospital is becoming one of the dissatisfactions in medical care. It is time that a general hospital should solve the parking problem in a desirable way. The purpose of this survey is to let the clients understand the basic motivation of the pay parking and develop the better parking system. Methods : Clients of a tertiary care hospital in Chon-ju were surveyed by means of a questionnaire. All in all, 193 subjects answered the questionnaire. Results : In relation to previous experiences, 39.6% of the subjects experienced inconvenience with confused parking lot and the shortage of parking space. Under the current parking system, the subjects who felt the available parking space was enough were more than those who didn't 62.7% of the subjects answered that they could find the parking lot easily. 33.2% of the subjects mentioned that it was not easy to drive in the parking area ; The reasons were pointed out the shortage of space, disordered parking, and insufficient guide. 12.8% of the subjects satisfied with the current administering system of parking lot. The outpatients were more affirmative than the admitted patients about the charging system. As for the parking fee, 64% of the subjects answered that it is expensive, and 89.5% of the subjects thought imposing of parking fee is irrational. Conclusion : To say as a whole, the basic purpose of the charging system are more or less accepted. However, the management details like parking facilities and payment method are dissatisfactory, so it is necessary to improve the management system. It is also noted that the inpatients showed more negative attitude than the outpatients with the charging system. To secure a more convenient parking, the parking system should be considered in relation to the information service, kind guidance, improve facilities, personnel cooperation, fix outpatient scheduling system, etc.
The purpose of this study is to analyze local-based social welfare facilities to respond to secular change of the UR rental housing estates in Japan. The selected case studies for the analysis are Hibarigaoka, Hamakousien, Turumai UR rental housing estates constructed around 1960's. The analysis was done through UR website, MLIT (Ministry of Land, Infrastructure, Transport and Tourism) and MHLW (Ministry of Health, Labour and Welfare) policy report, and related literature. These case studies are connected with housing policy as well as welfare policy and performed to Stable Living Creation Project by Business Entry System for Stable Living. The types of local-based social welfare facilities are classified by welfare corporation and medical corporation. The results are as follows: 1) The implementation of cooperative and participative system not only the private sector (welfare and medical Corporation, etc.) but also the public (MLIT, MHLW, UR Renaissance Agency, Local government, etc.). 2) Repurposed of land through rent and transfer of land for local-based social welfare facilities in the process of housing stock renewal utilization. 3) The pursue of regional revitalization through attached to multi-generation facility or local community space for elderly in local-based social welfare facilities.
The objectives of this study are : 1) To understand self-care ability, living habits, utilization patterns of medical facililties for the elderly in Puk-Cheju county which has the highest percent age of senior citizens among Cheju rural community: 2) To identify factors which influence living quality and long life for the eldely 3) To develop health care service with a view to guaranteering living quality The eldely population of Puk-Cheju county was $10.8\%$ in 1995. It will be increasing and is projeted $23.0\%$ by 2030. The result indicated that utilizations rate by out-patient were 5.89 claims and utilizations rate by in-patient were 0.17 claims per person. The highest disease among respondents were disease of musculoskeletal system and connective tissue. A total of 310 elderlys were responded to analyze self-care ability and health behavior. The most important factors of long life were to have peaceful mind$(50.0\%)$. The common disease of acute and chronic disease was musculoskeletal system disease. $66.8\%$ of respondents went to hospital and local clinic when they got sick. The most needed health care service was home visiting service among public health center, representing $31.4\%$. The repondent's self-care ability and self-efficacy were relatively superiority. A total of 92 elderlys were conducted the intelligence test for the rate of dementia and their average age was 74.3. The result of Minimental State Scale indicated that 25% of respondents were suspected to be dementia. The followings are recommendations based on the survey result. 1) Concidering every conditions of self-care ability and health status for elderly. It is important to embody appopriate health care service. 2) Considering concrete method, it is necessary to establish health service, which match health status and self-care ability, and various planning for sepecial facilities for the elderly. 3) It is desiable to make actual programs for the elderly in each community level. 4) It must be develop the better use of volunteers and programs for prevention of dementia. Finally, Concerning the orgarnization of public health center, community health center need to be reorganized for health service for the elderly. It is important to develop and operate health promotion for the elderly, and it is necessary to form the foundation for the support of facilities equipments. This contribute to promote health status for the rural elderly.
Objectives: This study was aimed at evaluating the effects of changes in the oral environment of the elderly in long-term care facilities after the intake of Weissella cibaria. Methods: The test group ingested the W. cibaria strain Chonnam Medical University (CMU), and the control group ingested the control food. Of all randomized trial subjects, 62 were analyzed (32 in the experimental group and 30 in the control group). In this 8-week demographic study, we evaluated self-perceived halitosis, changes in halitosis, sensory test results, tongue plaque index scores, saliva buffering capacity, and the salivary flow rate. Results: The W. cibaria CMU intake in the elderly in long-term care facilities during the experimental period did not demonstrate statistically significant changes in the salivary flow rate. However, self-perceived halitosis, organoleptic test results, tongue plaque index scores, and salivary buffering capacity demonstrated statistically significant differences between the experimental and control groups. These findings partially confirmed the beneficial effects of the W. cibaria CMU on the oral environment in the elderly. Conclusions: Research results on the role of probiotics in the oral cavity should be summarized, and utilization plans should be sought to obtain a clearer understanding of the clinical efficacy and related factors. The value of probiotic use may be high in improving the oral health of people by enabling treatment and prevention.
The purpose of this study is to identify a potential user's need for use and operational of the elderly day care center and to identify the problems and suggest development directions. The data collection was conducted on 320 ordinary people living in J-do through a questionnaire, and sought to understand the operational status of in-depth interview institutions for the heads and employees of six center. As a result of the analysis, a potential user's ware not aware of the functions and specific roles of day care center, the cost of facilities was covered by the government, and that facilities and the environment were important factors when using the center. In-depth interviews show that the current policy or system is far from reality and does not fit the status or role of the workers and the operational status of the agency, requiring the re-establishment of the on-site system. Based on the research results, the development direction of day care facilities requires active promotion and strengthening of family support for improving and enhancing awareness of day care facilities to citizens at the national level. Second, the quality of nursing services should be enhanced through improvements in facilities and the environment that reflect users' needs. Third, The government should improve the quality of nursing services by improving the poor employment conditions and treatment of workers to fit the reality.
This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.
Journal of agricultural medicine and community health
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v.28
no.2
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pp.87-105
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2003
Objectives: The purpose of this study was to examine the health care utilization pattern and its related factors of low-income population with abnormal results through health examination. Methods: Analysed data were collected through a questionnaire survey, which was given to 263 persons who 30 years or over with abnormal results through health examination at Health Center. This survey was conducted in March, 2003. This study employed Andersen's prediction model as most well known medical demand mode and data were analysed through 2-test, and multiple logistic regression analysis. Results: The proportion of medical utilization for thorough examination or treatment among study subjects was 51.0%. In multiple logistic regression analysis as dependent variable with medical utilization, the variables affecting the medical utilization were 'feeling about abnormal result(anxiety versus no anxiety: odds ratio 2.25, 95% confidence intervals 1.07-4.75)', 'type of health security(medicaid type I versus health insurance: odds ratio 2.82, 95% confidence intervals 1.04-7.66; medicaid type II versus health insurance: odds ratio 3.22, 95% confidence intervals 1.37-7.53)', 'experience of health examination during past 2 years(odds ratio 2.39, 95% confidence intervals 1.09-5.21)' and 'family member's response for abnormal result(recommendation for medical utilization versus no response: odds ratio 4.90, 95% confidence intervals 1.75-13.75; family member recommended to utilize medical facilities with him/her versus no response: odds ratio 19.47, 95% confidence intervals 5.01-75.73)'. The time of medical utilization was 8-15 days after they received the result(29.9%), 16-30 days after they receive the result(27.6%), 2-7 days after they received the result(20.9%) in order. The most important reason why they didn't take a medical utilization was that it seemed insignificant to them(32.4%). Conclusions: In order to promote medical utilization of low-income population, health education for abnormal result and its management would be necessary to family member as well as person with abnormal result. And follow-up management program for person with abnormal result through health examination such as home-visit health care would be necessary.
The aim of this study sets out to discover a desirable form of public centers among the alternative ones and make a health center model. Especially, this study attempts; (i) to investigate factors that affect the performance of health centers; (ii) carry out cost-effectiveness analysis (CEA) for the various type of health centers; (iii) identify innovative strategies to increase the use of health center. Cost-effectiveness analysis is used to compare the performance of all the centers. The following is taken to create the index. Wi = Ti x Mi x Eij (Wi: weight for service item I, Ti : time spent for service I, Mi ; number of health personnel involved in service I, Eij : years of schooling for personnel j in providing service I). As a result of these analyses, policy options as follows are recommended; (i) proper manpower, especially public health physician (oriental medical doctor), should be enough to provide health care adequately; (ii) facilities ad equipments in the health center should be provided sufficiently. (iii) the utilization of health centers should be raised by active operation of mobil service, community participation and health education program. Ultimately health centers in public sector are to be fostered for the promotion of health care by enhancing the financial and quality, continuity and efficiency of health services.
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