• 제목/요약/키워드: health care delivery system

검색결과 305건 처리시간 0.031초

Predictors of the Utilization of Oral Health Services by Children of Low-income Families in the United States: Beliefs, Cost, or Provider?

  • Kim Young Ok Rhee;Telleen Sharon
    • 대한간호학회지
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    • 제34권8호
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    • pp.1460-1467
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    • 2004
  • Purpose. This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. Methods. In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. Results. The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on week-ends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. Conclusion. The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.

보건소 중심의 물리치료 활성화 모델 (A Model of Activation in Physical Therapy of Public Health Center)

  • 배성수;김중선;이한숙
    • The Journal of Korean Physical Therapy
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    • 제11권3호
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    • pp.123-131
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    • 1999
  • The purpose of is study deals with the physical therapy and the delivery system of public health center, as a center, in community based rehabilitation and delivery system. We hope that the system of physical therapy of public health center in community based rehabilitation spreads all over the country and contributes to the promotion of national health and social welfare. There are many public health center in the country because it can serve inhabitants with the medical benefits in the Erst line. public health center continuously provides poor inhabitants who cant pay medical expenses care of health. It has the public health center branches that take care of inhabitants who live a remote village and hiterland. Additionally, many people want to receive physical therapy. Therefore, the physical therapy of public health center becomes the central paint in community based rehabilitation so that we supply the inhabitants with superior rehabilitation service. We can approach them as a team that be constituted with physical therapist speech therapist, psychologist, nurse, social work. Also the role of physical therapist is divided into two parts, which are home visiting part that individually takes can of patients nod public health part that takes care of patient, family, home, community. We connect with both self-governing body and the government so that we may receive government subsidies. Also, we must prepare regular school education for community based rehabilitation

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지역사회 중심 가정간호사업 운영연구(가정간호사업 운영을 위한 정보전달체계 개발Ⅱ) (An Operations Study on the Home Care Nursing Delivery System)

  • 박정호;김매자;홍경자;한경자;박성애;윤순녕;이인숙;조현;방경숙
    • 가정간호학회지
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    • 제5권
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    • pp.20-31
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    • 1998
  • The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

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만성질환 관리 평가도구를 이용한 보건소 만성질환 관리수준 평가 (Evaluating Chronic Care of Public Health Centers in a Metropolitan City)

  • 최용준;신동수;강민아;배상수;김재용
    • 보건행정학회지
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    • 제24권4호
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    • pp.312-321
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    • 2014
  • Background: To evaluate the quality of chronic care provided by public health centers located in a South Korean metropolitan city using a modified Assessment of Chronic Illness Care (ACIC). Methods: We conducted self-evaluation surveys and collected data using a modified ACIC from twenty five public health centers. Cultural validity of the original ACIC was examined by the public health and nursing science experts. Based on expert reviews, cognitive interviews, pre-test results, five items of the original ACIC that were not relevant were deleted. The response scale was changed from twelve-point Likert scale to Guttman scale but its scoring system was maintained. Results: Eighty eight percent of public health centers in this study reported that their overall quality of chronic care was at a limited or basic level. About 68% of the centers reported that the organization was as reasonably good or fully developed to provide chronic care. On the other hand, 96% of the public health centers reported that the clinical information system was at a very limited or basic support level. The decision support, the integration of Chronic Care Model components, the delivery system design, the community linkages, and the self-management support were evaluated as limited or basic level of support by more than half of the public health centers, respectively. Conclusion: In a metropolitan area of South Korea, quality of chronic care in public health centers was not found to reach acceptable levels of services. It is critical to enhance the quality of chronic care in public health centers.

농촌형 노인 주간보호시설 모형개발 (Development of a Model of a Day Care Center for Rural Elderly People)

  • 강경숙
    • 지역사회간호학회지
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    • 제15권4호
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    • pp.551-565
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    • 2004
  • Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

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종합전문요양기관의 간호전달체계에 대한 실태조사 연구 (Survey on Nursing Care Delivery Systems of University Affiliated Hospitals in Korea)

  • 김소선;채계순;김경남;박광옥;문성미
    • 임상간호연구
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    • 제16권1호
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    • pp.167-175
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    • 2010
  • Purpose: This study investigated nursing care delivery systems in 44 university affiliated hospitals and satisfactions with the systems perceived by 226 unit managers (head nurses) of general medical surgical wards. Methods: Data were collected with questionnaires consisting of checklists asking the unit managers their nursing care delivery systems and their satisfactions with the systems. Results: Four models of nursing care delivery systems (primary, modified primary, team, and functional models) were drawn from the participants' responses. Among the four key models 35% of the units adopted team model whereas 24.3% adopted primary model and 22.6% adopted modified primary model. In spite of 35% of team model being under use, 60.6% (n=137) of the unit managers answered the nursing delivery system of their units as team model and only 6.2% (n=14) answered their units having primary or modified primary models, instead of 46.9% combining both. In regard to the satisfaction, critical thinking ability of staff nurses (members in their units) was the most dissatisfactory area regardless of models of service delivery. Conclusion: Introducing team model supplemented with core concepts of primary model (primary team delivery model) into nursing practice will reform the workplace and therefore deliver safe health care services to patients.