• Title/Summary/Keyword: disparity adjustment

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Disparities in Health Care Utilization Among Urban Homeless in South Korea: A Cross-Sectional Study

  • Yoon, Chang-Gyo;Ju, Young-Su;Kim, Chang-Yup
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.6
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    • pp.267-274
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    • 2011
  • Objectives: We examined health care disparities in Korean urban homeless people and individual characteristics associated with the utilization of health care. Methods: We selected a sample of 203 homeless individuals at streets, shelters, and drop-in centers in Seoul and Daejeon by a quota sampling method. We surveyed demographic information, information related to using health care, and health status with a questionnaire. Logistic regression analysis was adopted to identify factors associated with using health care and to reveal health care disparities within the Korean urban homeless population. Results: Among 203 respondents, 89 reported that they had visited health care providers at least once in the past 6 months. Twenty persons (22.5%) in the group that used health care (n = 89) reported feeling discriminated against. After adjustment for age, sex, marital status, educational level, monthly income, perceived health status, Beck Depression Inventory score, homeless period, and other covariates, three factors were significantly associated with medical utilization: female sex (adjusted odds ratio [aOR, 15.95; 95% CI, 3.97 to 64.04], having three or more diseases (aOR, 24.58; 95% CI, 4.23 to 142.78), and non-street residency (aOR, 11.39; 95% CI, 3.58 to 36.24). Conclusions: Health care disparities in Seoul and Daejeon homeless exist in terms of the main place to stay, physical illnesses, and gender. Under the current homeless support system in South Korea, street homeless have poorer accessibility to health care versus non-street homeless. To provide equitable medical aid for homeless people, strategies to overcome barriers against health care for the street homeless are needed.

Association Between Convenience of Transportation and Unmet Healthcare Needs of Rural Elderly in Korea

  • Choi, Youngeun;Nam, Kiryong;Kim, Chang-yup
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.6
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    • pp.355-365
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    • 2019
  • Objectives: In rural areas of Korea, where public transportation infrastructure is lacking and alternative systems are poor, the elderly experience inconveniences in using healthcare, although their need is high. This study aimed to analyze the association between the convenience of transportation and unmet healthcare needs among the rural elderly. Methods: The data used were collected in the 2016 Community Health Survey among rural elderly individuals aged 65 or older. Dependent variable was the unmet healthcare needs, explanatory variable was the convenience of transportation. The elderly were divided into 3 groups: with no driver in the household, with a driver, and the elderly individual was the driver (the self-driving group). Covariates were classified into predisposing, enabling, and need factors. They included gender, age, education, income, economic activity, household type, motor ability, subjective health level, number of chronic diseases, anxiety/depression, and pain/discomfort. The data were analyzed using logistic regression and stratification. Results: A significant association was found between the convenience of transportation and unmet healthcare needs. When examined unadjusted odds ratio of the group with a driver in the household, using the group with no driver as a reference, was 0.61 (95% confidence interval [CI], 0.54 to 0.68), while that of the self-driving group was 0.34 (95% CI, 0.30 to 0.38). The odds ratios adjusted for all factors were 0.69 (95% CI, 0.59 to 0.80) and 0.79 (95% CI, 0.67 to 0.91). Conclusions: We confirmed a significant association between inconvenient transportation and unmet healthcare needs among the rural elderly even after adjustment for existing known factors. This implies that policies aimed at improving healthcare accessibility must consider the means of transportation available.

Analysis of Research Papers Published by the Korean Journal of Hospice and Palliative Care (The First Issue~2012) (한국 호스피스.완화의료학회지 게재논문 분석(창간호~2012년))

  • Hwang, In Cheol;Kang, Kyung-Ah;Ahn, Hong Yup
    • Journal of Hospice and Palliative Care
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    • v.16 no.2
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    • pp.74-79
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    • 2013
  • The purpose of this paper is to suggest a direction for future studies based on the analysis of the articles published in the Korean Journal of Hospice and Palliative Care from 1998 to 2012. A total of 240 articles (51 reviews, 189 original) were examined in three five-year groups. Categories of analysis include authors' background (profession, region) and general characteristics and qualitative aspects of the original paper (participants, topic, study design, data analysis, ethical consideration, multidisciplinary approach, research funds and sample size estimation). While the journal publishes more of articles than before, it is mainly due to the increase in the number of review articles, not original articles. As for study topics, healthcare industry and physical symptoms were most frequently studied. The disparity in authors' regional background is fading, and more articles are published by nurses than before. Moreover, more studies are funded while fewer papers tend to adopt a multidisciplinary approach or focus on care givers. Also, in terms of a study design, the number of experimental and methodological studies has slightly increased. In the qualitative aspect, studies considered ethical issues and collected participation consent, and fewer studies reported an estimated sample size. In data analysis, post-adjustment comparison decreased, and new analytical methods are increasingly used. Our results indicate the need to conduct research with more extensive scientific data in various fields of hospice and palliative care.

Development of a Linking Model between Community Resourses and Industrial Injury Insurance Organs for the Activation of Medical Rehabilitation Services for Industrial Injury Patients (산재환자의 의료재활서비스 활성화를 위한 산재보험시설과 민간시설간의 연계모형 개발)

  • Kim, Hee-Girl
    • Korean Journal of Occupational Health Nursing
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    • v.14 no.1
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    • pp.56-70
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    • 2005
  • Objectives: The purpose of this study is to develop a linking model between industrial injury insurance organs and local organizations providing social welfare health services, for the activation of medical rehabilitation services for industrial injury patients. Method: Research design for this study was a multi-step research through literature review, field research, and group interviews with persons in charge, to compare local society-oriented medical rehabilitation programs. The term of researches Sep.1 ~ Nov. 30, 2004. Results: 1. Home nurses from Workers Accident Medical Corporation have been taken to be adequate to case managers, who link industrial accident insurance institutions to local society services for the activation of medical rehabilitation services for industrial injury patients. They have been chosen for case managers because they have richer understanding and experiences of objects of industrial accidents than any other specialists, and because they have proved to be able to provide direct home services as a specialist. We have established the center for case management affairs within the workers accident general hospital, organized the committee for case management with doctors in charge, doctors in rehabilitation, rehabilitation consultants, social welfare workers, physical therapists, and nurses, determined objects of case managements from those of long-term recuperation, and constructed a course of case management containing from case management plans to evaluation. 2. We have made files of community resources, and organized the council of industrial accident administration to have it in charge of the adjustment and linking of services in case management affairs. 3. Because there are inequality of community resources between areas, differences in experiences in and bases for linking, and disparity of core organizations with active linking in the system of linking between public and civil sectors, we have taken a system of linking between parallel organs to be the core. In our linking model, workers accident general hospital, hospitals designated for industrial injury, and rehabilitation hospitals are linked in parallel, inadequate long-term recuperation managers are trusted to an workers accident medical corporations through examination by the examination committee in Korea Labor Welfare Corporation, and are dealt with by the committee for case management. Of the hospitals designated for industrial accidents, those running a home caring center provide home caring services for the handicapped at home from industrial injury. 4. Workers Accident Medical Corporation take part in medical rehabilitation, and Korea Labor Welfare Corporation in vocational/social rehabilitation. Furthermore, in the model, the latter should construct a system for job opportunities through Internet portals and provide cyber vocational consultation and introduction. Conclusion: Improvement of systems is needed to apply the linking model to practical affairs. Because this model is centered for practical affairs, it should be put under the analysis of effects, and evaluation of its adequacy to practical application, and its effects and efficiency through experimental running in the 8 workers accident general hospital in Korea.

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Comprehensive Review of Quality Certification Follow-up Management Audit Outcomes Following the Dual Role as Quality Manager for Recycled Aggregate (순환골재 품질담당자 겸직 허용 이후 품질인증 사후관리 심사결과 고찰)

  • Jeon, Soo-Min
    • Journal of the Korea Institute of Building Construction
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    • v.24 no.2
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    • pp.239-248
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    • 2024
  • The adjustment in guidelines for quality certification of recycled aggregate permitted the Quality Control Manager of a company specializing in recycled aggregate quality certification to concurrently assume the role of Environmental Management Manager. Analysis of the outcomes from the 2023 recycled aggregate quality certification follow-up management audit conducted by the certification agency revealed that in 95 out of 242 cases, constituting approximately 39% of the total cases, individuals held concurrent positions. Following the regulatory revision, there has been a notable proliferation of concurrent roles across various enterprises. Concerns arose regarding the potential neglect of quality control for certified recycled aggregates in comparison to scenarios where individuals are solely responsible for specific duties related to quality and environmental management. Audit results encompassing six aspects, including waste management, were evaluated on a scale of 6 points. A comparative analysis was conducted between the outcomes of 147 cases managed by dedicated personnel, as previously practiced, and 95 cases managed by individuals with concurrent roles. Although the average score of the latter group was marginally lower, no statistically significant disparity was observed between the two groups. Consequently, apprehensions regarding the oversight of quality control stemming from the allowance of concurrent roles appear unfounded. Within the context of recent regulatory revisions, permitting concurrent roles in managerial capacities is deemed an appropriate relaxation of regulations.