• Title/Summary/Keyword: care policy

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Challenge of Personalized Medicine in the Genomic Era (유전의료시대의 "맞춤의학")

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.5 no.2
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    • pp.89-93
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    • 2008
  • "Personalized medicine," the goal of which is to provide better clinical care by applying patient's own genomic information to their health care is a global challenge for the $21^{st}$ century "genomic era." This is especially true in Korea, where provisions for clinical genetic services are inadequate for the existing demand, let alone future demands. Genomics-based knowledge and tools make it possible to approach each patient as a unique biological individual, which has led to a paradigm-shift in medical practice, giving it more of a predictive focus as compared with current treatment oriented approach. With recent advancements in genomics, many genetic tests, such as susceptibility genetic tests, have been developed for both rare single gene diseases and more common multifactorial diseases. Indeed, genetic tests for presymtomatic individuals and genetic tests for drug response have become widely available, and personalized medicine will face the challenge of assisting patients who use such tests to make appropriate and wise use of genetic risk assessment. A major challenge of genomic medicine lies in understanding and communicating disease risk in order to facilitate and support patients and their families in making informed decisions. Establishment of a health care system with provisions for genetic counseling as an integral part of health care service, in addition to genomic literacy of health care providers, is vital to meet this growing challenge. Realization of the promise of personalized medicine in the era of genomics for improvement of health care is dependent on further development of next generation sequencing technology and affordable sequencing test costs. Also necessary will be policy development concerning the ethical, legal and social issues of genomic medicine and an educated and ready medical community with clinical practice guidelines for genetic counseling and genetic testing.

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A Development of a Tailored Follow up Management Model Using the Data Mining Technique on Hypertension (데이터마이닝 기법을 활용한 맞춤형 고혈압 사후관리 모형 개발)

  • Park, Il-Su;Yong, Wang-Sik;Kim, Yu-Mi;Kang, Sung-Hong;Han, Jun-Tae
    • The Korean Journal of Applied Statistics
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    • v.21 no.4
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    • pp.639-647
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    • 2008
  • This study used the characteristics of the knowledge discovery and data mining algorithms to develop tailored hypertension follow up management model - hypertension care predictive model and hypertension care compliance segmentation model - for hypertension management using the Korea National Health Insurance Corporation database(the insureds’ screening and health care benefit data). This study validated the predictive power of data mining algorithms by comparing the performance of logistic regression, decision tree, and ensemble technique. On the basis of internal and external validation, it was found that the model performance of logistic regression method was the best among the above three techniques on hypertension care predictive model and hypertension care compliance segmentation model was developed by Decision tree analysis. This study produced several factors affecting the outbreak of hypertension using screening. It is considered to be a contributing factor towards the nation’s building of a Hypertension follow up Management System in the near future by bringing forth representative results on the rise and care of hypertension.

A Study on the Characteristics and Satisfaction of the Recipients of Home Care (재가복지대상자의 특성과 서비스 만족도)

  • Han, Hye-Kyung
    • Korean Journal of Social Welfare
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    • v.37
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    • pp.429-448
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    • 1999
  • The objectives of this research are (1) to identify characteristics and needs of the recipients of home care, and type of services (2) to examine the factors that predicts the degrees of recipients' satisfaction. This study uses the data based on the responses of 490 recipients selected randomly from 22 home care centers. The results show that recipients have higher frequencies in age of 60+, disabled status, difficulty with ADL, IADL items, no family, and lowest class. And the type of services offered by home care centers have highest frequencies in home maker services. Recipients' attitude toward home care services is "helpful," but they are not satisfied with the frequency of visit. The study found that disabled status, difficulty with ADL, IADL, health services, and home maker services are negatively related with degrees of recipients' satisfaction. Based on the findings, the study would conclude that home care policy should be recipients' need-based, developing systematic: need assessment tool. Expanded home health caring must be required for the disabled elderly.

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Comparing Two Mycobacterium tuberculosis Genomes from Chinese Immigrants with Native Genomes Using Mauve Alignments

  • Ryoo, Sungweon;Lee, Jeongsoo;Oh, Jee Youn;Kim, Byeong Ki;Kim, Young;Kim, Je Hyeong;Shin, Chol;Lee, Seung Heon
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.3
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    • pp.216-221
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    • 2018
  • Background: The number of immigrants with tuberculosis (TB) increases each year in South Korea. Determining the transmission dynamics based on whole genome sequencing (WGS) to cluster the strains has been challenging. Methods: WGS, annotation refinement, and orthology assignment for the GenBank accession number acquisition were performed on two clinical isolates from Chinese immigrants. In addition, the genomes of the two isolates were compared with the genomes of Mycobacterium tuberculosis isolates, from two native Korean and five native Chinese individuals using a phylogenetic topology tree based on the Multiple Alignment of Conserved Genomic Sequence with Rearrangements (Mauve) package. Results: The newly assigned accession numbers for two clinical isolates were CP020381.2 (a Korean-Chinese from Yanbian Province) and CP022014.1 (a Chinese from Shandong Province), respectively. Mauve alignment classified all nine TB isolates into a discriminative collinear set with matched regions. The phylogenetic analysis revealed a rooted phylogenetic tree grouping the nine strains into two lineages: strains from Chinese individuals and strains from Korean individuals. Conclusion: Phylogenetic trees based on the Mauve alignments were supposed to be useful in revealing the dynamics of TB transmission from immigrants in South Korea, which can provide valuable information for scaling up the TB screening policy for immigrants.

Child Care Histories of Low-Income Families in the U.S. (미국 저소득층 가정의 보육형태의 생애사적 연구)

  • Auh, Seong-Yeon
    • Journal of the Korean Home Economics Association
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    • v.48 no.6
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    • pp.103-118
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    • 2010
  • This study used qualitative data to examine how low-income families confront the child care needs of their children in the midst of changes in public policy. The data were drawn from in-home interviews conducted every 6 months with 22 mothers who were welfare-dependent at the start of the research. This research depicted several life stories of the circumstances of poor children that have not had much previous attention in the literature: the general flows and the special conditions of child care among the low-income families with or without a disabled child were reported. The results in this study suggested that enabling families, through both social support and public funding, find affordable and quality child care would be one pathway to foster self-sufficiency in these families.

A Study on Stress Responses of Korean-American (한국인의 스트레스 반응양상 -미국이민 한국인을 대상으로-)

  • 이소우
    • Journal of Korean Academy of Nursing
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    • v.22 no.2
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    • pp.238-247
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    • 1992
  • Immigration of Koreans to the United States has increased since the 1960's. Adjusting to life in the United States produces a great deal of stress for immigrants. Despite better economic opportunites, many see the U.S. culture as threatening to their family and cultural values. Differences in culture, language, expectations and social behavior can lead to misunderstandings between health care providers and clients. These misunderstanding can leaf to frustration on the part of each. The ultimate result of this is that often Korean-immigrants do not get their health care needs met and stress response symptoms can lead to disease if there is no appropriate care. To determine the health care needs and concerns of Korean-Americans, a health needs assessment is needed. Appropriate and adequate information about the health care needs of these individuals is important as it relates to American policy changes allowing greater numbers of immigrants to enter the U.S. The purpose of this prospective study was to describe Korean-American stress response. This study focused on the primary presenting problems for which subjects reported having sought care. These included a variety of stress-related symptoms, including peripheral manifestations, cardiopulmonary symptoms, central-neurological symptoms, gastrointestinal symptoms, muscle tension, habitual patterns, depression, anxiety, emotional irritability and cognitive disorganization. Of the 300 subjects who entered the study, 80% (N=223) completed the questionnaire in full. Demographically, the percentage of females and males was 50% each and they ranged in age from 20 to 69 years. Ninety percent of the subjects were highly educated, 25% owners of business, 25% white collar professionals, 15% employed in sales or as skilled /unskilled labor, 30% had no occupation : and 5% were housewives or students. The SOS inventory is designed to quantify self-perception of behavioral, cognitive, and physiological components of the stress response. It consisted of 94 items divided into 10 subscales. The result of this study are as follows : The total mean 505 of all subjects (N=223 was .8129 ; the mean 505 for male(N=114) was .7665 and for females, (N=108) .8594. The level of symptoms for central-neurologic and muscle tension was higher for than for males. The highest stress response of all subjects was emotional irritability symptoms(1.0644) : the lowest stress response of all subjects was peripheral manifestation symptoms.

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Attitude of Elderly People on Life Support Care -Q Methodological Approach- (노인의 연명치료에 대한 태도 -Q 방법론적 접근-)

  • Kang, Da-Young;Shim, Hyung-Wha
    • The Journal of the Korea Contents Association
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    • v.15 no.12
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    • pp.355-369
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    • 2015
  • Purpose: This study aimed to identify on the attitudes toward the life support care among elderly people using Q methodology. Methods: Thirty-nine elderly people classified 34 selected Q statements into a shape of normal distribution using a 9 point scale. The obtained data were analyzed by using a PQ Method PC program. Results: Principal component analysis identified 4 types of the attitudes toward the life support care among elderly people. Type I is "Situational & Self-determination linear type", type II is "Destiny & Life support care denied type", type III is "Avoidant & Family decision emphasis type" and type IV is "Respect for life & life support care approved type". Most of elderly people have been attitude that wish to receive honor their own decisions toward the prolongation treatment. Conclusion: The findings indicate a need to policy guidelines and public information that express self-determination of elderly people.

Factors Influcing Elderly Care Burden of A Working Family in Korean Nursing Facilities: A Convergence Approach (한국 요양시설을 이용하는 직장인 가족의 노인 돌봄 부담감에 영향을 미치는 요인)

  • Sung, Kyung Mi;Kim, Eun Jeong
    • Journal of Digital Convergence
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    • v.18 no.2
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    • pp.333-342
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    • 2020
  • The purpose of this study was to identify factors influencing elderly care burden of a working family. Methods: A descriptive correlational design was used. Participants was 153 family member of elderly at five nursing facilities. Data were collected through self-reported questionnaires from July to October 2019. Data were analyzed using an independent t-test, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis with the SPSS WIN 25.0 program. Analysis result, explaining 20,8% of the variance, which indicated that subjects for giving care, monthly admission fee, burden of expenses, and satisfaction for fee service were significant predictors of working family's care burden. Various individual characteristics significantly influenced working family's care burden in aspects of emotional, social, economical, and physical burdens. Therefore, interventions to decrease working family's care burden must focus on their individual factors.

Medical costs for patients with Facial paralysis : Based on Health Big Data (보건의료 빅데이터를 이용한 얼굴마비환자의 의료비용에 관한 연구)

  • Hong, Min-Jung;Umh, Tae-Woong;Kim, Sina;Kim, Nam-Kwen
    • The Journal of Korean Medicine
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    • v.36 no.3
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    • pp.98-110
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    • 2015
  • Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.

Evaluation Study of Home Health Care Program Operated in G Public Health Center (인천광역시 일 보건소 대도시 방문보건사업의 평가 연구)

  • Kim, Myung-Soon;Kim, Young-Sook
    • Research in Community and Public Health Nursing
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    • v.15 no.4
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    • pp.539-550
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    • 2004
  • Purpose: The purpose of this study was to evaluate the achievements of the project, and also to find out its strengths and weaknesses. Method: This evaluative study employed system theory and analytic techniques by using criteria which were relevance, appropriateness, adequacy, progress, effectiveness and satisfaction for input, process, output, and outcome of program. Study subjects were participants in the home health care program implemented in G public health center in Inchon metropolitan city in 2003. Results: Input factors including recruitment personnel, and support organization development were not adequately met for the program. However. the goal and objectives of the project were really appropriate for the community needs as well as government's policy. For the Process evaluation, home health care record form and computer data base had not progressed as scheduled, but overall program activities were finished on time. However, cooperation between organizations in the health center during service activity were not supportive. Managerial ability of program charged personnel about coordination and integration of team members was not affirmative. Output and outcome evaluation showed that people improved self care ability were 221 (17.5%). and 71 (5.62%) of subjects were moved into category of possible self-care. Client's satisfaction for this project showed a high degree. Conclusions: Based on the above results support organization and staff personnel for this program should be developed. Also, a community network of resources should be established and case management services should be focused continuously in community based home health care.

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