This paper provides the guidelines from which to develop a visiting health care program at the Public Health Center in Korea and involves an expanded payment compensation system of preventive services based on the new long-term health insurance system in Japan. The function and management methods to achieve the goals practiced in a community contact center for elderly support which have recently been established will guide the specific directions and strategies that the Public Health Center should pursue. That is to say, comprehensive and continuous efforts will be put forth in preventive home visiting care targeting the elderly in certain jurisdictions. At this point in time in which the visiting care nursing program has not yet started, visiting health care provided by the Public Health Center oversees chronic diseases of a vulnerable population. But after it has been developed nationwide, the visiting health care system at the Public Health Center will be distinctive and focused on health promotion and prevention.
Journal of agricultural medicine and community health
/
v.16
no.2
/
pp.125-133
/
1991
The medical insurance system has been adopted in rural areas in 1988. Since then, the utilization of medical care services has increased rapidly in rural areas. According to the various study on medical care utilization, the people in rural areas used more curative care services than urban areas. The purpose of this study was to analyze the utilization and expenses of medical care services in designated rural areas : Choonseong Gun, Kangwon Province ; and Soonchang Gun, Cheonbuk province in Korea. Medical care utilization of medical care beneficiaries showed slightly increase, while there was a decrease of 18% and more for the medicaid. Regarding selection of medical care institutions, medical care beneficiaries used more hospitals and clinics than health center networks, but the health center networks was used more by the medicaid. However, the hospitalized Soonchang health center was able to provide more curative care to the people than the other two health centers. More than 50% of the patients treated by hospitalized health center were residents of the place in which health center was located.
In order to investigate the basic data for the visiting nursing care plan of Health Center in Korea, the questionnaire survey in regard to health care needs and health problems of the subjects with visiting nursing care was carried out on 131 subjects with visiting nursing care. The results were as follows : 1. The subjects consisted of 38.2% in male and 61.8% in female. 77.1% of the subjects had no job. 2. In the health problem, the subjects symptoms were 31.2% of hypertension, 20.6% of arthritis, and 19.1% of diabetes and other chronical illness. Utilization of medical care facilities were 61.8% of private clinics or general hospitals and 29.0% of Health Center. 3. 10 areas of health care needs that subjects wanted were disease management(19.5%), demand for welfare concerns(15.7%), health promotion and disease prevention(14.2%), information for medical institution(12.3%), health management for the aged(10.8%), hospice care(8.0%), prevention of dementia(8.0%), care for mental hygiene(6.7%), management for drinking, smoking and drug abuse(3.3%), home care nursing and rehabilitation nursing(1.2%).
Poverty directly affects health and well-being, The poor population has a higher rate of chronics illness. higher infant morbidity and motality rates. shorter life expectancy. more complex health problems. and greater physical limitations resulting from chronic disease. In order to activate primary health care for the poverty in urban area the following measures should be taken : 1. Health center must be expended or establish subhealth center. 2. Health center must monitor neighbour's workplace's health management for their working population. 3. Health centers must do active home visiting nursing care for the urban-poor. 4. Health center must carry out flexible problem-centered practice according to the area. 5. For the urban-poor's health care must have organization of the health center & practice according to community's characteristics. 6. Public health care must be closely connected with welfare. 7. For the health care of the urban-poor must demand active community participation. 8. Health center is closely connected with Community hospital. 9. Active management of public health resource system is demanded.
Thus, I studied Health services supplied by local health centers and the requirements of the inhabitants visiting the health care facilities. The purpose of this study was to provide basic material for the establishment of Health care policy and the development of health care businesses. The target places for this study were 4 health centers; Chungrang-Gu, Nowon-Gu, Eunpyung-Gu, Songpa-Gu, with 509 mothers who were visiting the Centers. The question items of this study concerned a total of 124 health-related services provided by the Health Centers. The data was collected for a total of 92 days; July 1st~September 30th, 1999. 800 questionaries were distributed and 559 answered, 509 were analyzed finally. The collected data were processed using the SAS program to get mean, standard deviation, percentage. Open questions were made to reveal the opinions of mothers using the health care center. The results were as follows : 1. Among the participants of the study, 49.7% were 25~29 years of age, 84.3% were house wives by current occupation, 56.2% were from 4~6 person households. 52.1 were educated at a high school level, and 43.6% were educated at a collage level. 2. The highest percentage(53.6%) of the users were spontaneous in their utilization of health care center. The major reason for using the Health care center is that it is free to 65.8% of those covered and of low cost to 19.3% of those covered. 3. The satisfaction level of those using the health care center appeared to be generally high. The general average value showed up as $3.027{\pm}0.519$. 4. The level of recognition of the value of the heath care center services was high, particularly in the basic item of diagnoses of pregnancy, particularly in the basic item of diagnoses of pregnancy. However, the satisfaction level of health care education In pregnancy is low at 20~40%. In the meantime, the level of recognition in breast- feeding benefits is high at 76.8%. 5. The rate of realizing health care center's service campaign was generally low at 10~20%. 41.3 of the people knew the advertizing material of the health care centers. 32.4% of the people knew the advertizing material of the health care centers. 32.4% of the people knew the campaign of health care center for importance of breast-feeding benefits. 30.1% of the people knew the campaign for testing congenital mechanism disease. In the meantime about 50% was recognised the health care centers campaign for the importance and time of infants vaccination. 6. The need for enhancement of health care center services was shown to be high as $3.266{\pm}0.676$ as an average, chicken pox vaccination being the most highly requested at $3.565{\pm}0.587.$. 7. Among the open questions, the additional service to be provided were as follows ; increase of campaign of health care center services, furnishing advertizing books in public locations, providing shuttle bus service to the health care centers, extension of desire for preventative injections, rest and play areas for the children of the families serviced, consultation rooms, etc.
Purpose: To investigate health problems in child day care centers, needs for Child Care Health Programs, and management of sick children by day-care staff. Methods: A cross-sectional descriptive study. Day-care staff (N=206) from 33 day care centers in Seoul, completed a structured questionnaire. Results: Almost half of the day-care staff (53.4%) experienced sick events in their child at least once a month. The most frequently reported difficulty in having a sick child was in not having a health professional to consult, and almost all day-care staff (99.5%) had asked parents not to bring a sick child to the day care center. The biggest reason of exclusion was due to infectious disease including measles, chicken pox, mumps, diarrhea·vomiting, and pink eye. The majority of day-care staff (97.6%) agreed that there is a need for Center-based Child Care Health Program (CCCHP), and expected general health & illness management, and special care for chronic disease from CCCHP. Conclusion: These results showed a high incidence of sickness in children in day care centers, and there were great demands for a Center-based Child Care Health Program for day-care staff. Also the results of this study can be utilized as a basis for the establishment of child care policy in Korea.
Purpose: This study was conducted to investigate the recognition on center-based child care health programs for parents with ill children. Methods: Cross-sectional descriptive study with convenient sampling method was used and 136 parents were recruited from two university hospital outpatient departments and hospitalized wards, and they completed a structured questionnaire. Results: Majority (57.4%) of parents experienced a leaving work early or being absent from their work due to children's illness. Most dissatisfying factors in child care centers were child health management. Most of parents agreed on the need for a center-based child care health program, and wanted a better management of health care by health professionals in child care centers. Conclusion: These results support that there is a great demand for center-based child care health programs. These special programs are needed for reducing a child rearing burden for working mothers and overcoming the low birthrate in Korea. Health-care programs in child-care settings can help parents meet the health needs of their children while reducing absenteeism from work, thereby contributing to job stability. These results suggest discussions of the related policy with child care centers responsible and national health and educational authorities.
Purpose: The aim of this study was to evaluate the effects of oral health care programs in 3 school-based oral health care center among primary schoolchildren. Methods: School-based oral health care programs included fluoride mouth rinsing, pit and fissure sealing for permanent premolars and molars, fluoride gel application and chewing of xylitol candy. All of the programs were carried out by one dental hygienist among 'D' primary schoolchildren in Daegu city under the supervision of a dentist. Baseline dental examinations were completed and preventive care was implemented for 544 children during one year. All of the children visited a school-based oral health care center every three months for a regular check-up. The final oral examination was conducted from March 15 to April 1, 2004. The data analysis data was made on the basis of SAS 8.01. Mean differences between 2003 and 2004 data were compared by paired t-test. Corresponding p-values were considered significant at values less than 0.05. Results: The DMF rate and DFT index were reduced to 8.0% and 8.4% during one year respectively, but there were no statistically significant differences. The DMF rate was significantly reduced (16.3%) after a one year program of school-based oral health care practice. The DMFT(Decay Missing Filling Tooth) index was also reduced compared to 2003 throughout the entire grade. Conclusion: School-based oral health care programs can reduce the prevalence of dental caries prevalence among schoolchildren during one year. This program also improved the oral health capacity of schoolchildren. It is recommend that the school-based oral health care program should be extended to every primary school in Korea.
Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.
The aim of this study was to examine differences in the level of satisfaction with medical care at a public health center between patients receiving free-care compared to those paying out-of-pocket. SERVQUAL(Comprehensive Service Quality Measurement Scale), a pyschometrically valid measure for evaluating hospital service quality, was used to assess patient satisfaction. The study sample consisted of 279 patients who received medical care at a public health center. The interview was conducted between April 23 and May 7, 1998. The results was as follow: 1. There were more elderly people among free-care patients than out-of-pocket patients. Education and income levels were lower amongs those receiving free-care. There were, however, no differences in the distribution of gender and religion between the two groups. Patients receiving free-care tended to visit the public health center more frequently compared to those self-paying patients. 2. Overall, free-care patients showed higher satisfaction level than that of self-paying patients. except for the dimension on sympathy and shape.
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