• 보건행정학회지
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• 제22권1호
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• pp.85-108
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• 2012

One of the ways to achieve the principle of equal access for equal needs, availability and geographical accessibility of health care resources regardless of resident sites is important. The purpose of this paper is to measure socioeconomic inequities in distribution of health care resources among regions in the Republic of Korea (hereafter Korea). Data were extracted from regional statistics of National Health Insurance, Community Health Survey, Korea Social Science Data Archive, and Korean Statistical Information Services at the same period of 2009. The dependent variables were the number of health workforce and health care facilities in each region. The proxy indicator of regional socioeconomic status was local tax per person. To identify whether inequalities among regions, we examined the concentration index(CI) and indirectly standardized CI by controlling each region's demographics and need factors. Total observations were 232 districts in nationwide, and we analyzed separately Seoul(25 districts) and non-Seoul areas(207 districts). The standardized CI values of health care resources were positive(favoring the rich region) across the nation in almost all kinds of resources. Especially the number of specialist, dentist, dental clinics, clinics, oriental medical clinics, pharmacists, and pharmacies were statistically significantly favoring the rich region. But the CI for the number of long-term care hospitals, public health centers were negative(favoring the poor region). The tendency of CI presenting positive values were increased in Seoul area. But in the case of non-Seoul, the CI indexes were nearly zero. The results suggest that except the Seoul area, little regional socioeconomic-related inequalities were observed in the distribution of health care resources in Korea.

• 지역사회간호학회지
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• 제20권2호
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• pp.123-133
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• 2009

Purpose: This study aimed to classify nursing interventions by developing a list of interventions for family nursing care. Methods: A new intervention list was confirmed after the researchers' discussion and professional consult. All possible interventions were re-organized. Results: Five grand categories were identified, which include health education, providing direct nursing care, utilization and referral of community resources, reinforcing family resources, and stress management. The category of health education consists of anticipatory guidance, training and education, providing information, and consult and motivation. The category of providing direct nursing care consists of identifying problem, providing technical nursing, providing family tailored nursing care, family contract, monitoring or evaluation, and collaboration with experts. The utilization and referral of community services includes utilization of health care facilities, utilization of social welfare facilities, use of neighbors, friends, and relatives, connecting to professionals or supporting groups, and utilization of other sources. Reinforcing family resources includes reinforcing economic resources, reinforcing physical resources, and reinforcing human resources. Stress management includes reorganization of perception, resolving conflicts, division of role, preparing communication strategies, time management, creating familiarity, supporting spirituality, and developing sense of humor. Conclusion: This study provides useful resources to promote nursing activities by identifying possible family nursing interventions.

• 한국병원경영학회지
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• 제9권3호
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• pp.18-48
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• 2004

Health policies in many countries have come under critical scrutiny in recent years. This is because of increasing national health expenditures. Also many persons in health sector have been the perception that resources allocated to health services are not always deployed in an optimal fashion. And they believe that the scope of resources in health services is limited, there is need to search for ways of using existing resources more efficiently. A further concern has been the desire to ensure access to healthcare of various groups on an equitable basis. In some European countries this has been linked to a wish to enhance patient choice and to make service providers more responsive to consumers, while Korea integrated health insurance funds into single fund in 2000. Many European countries are under considerable pressure to review and restructure their health care systems. There are several reasons of pressure to reform. There are demographic changes, pattern of disease change, advances in medical sciences will also give rise to new demands within the health services, public expectations of health services are rising as those who use services demand higher standards of care. These circumstances require the change of health care delivery system based on hierarchical regionalism, which was basis of health care delivery since 1920s. Korea is also under similarly pressure to restructure our own health care systems. We will have good learning from OECD experiences. In this paper we reviewed and compared among OECD countries' various experiences.

• 보건행정학회지
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• 제22권3호
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• pp.403-426
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• 2012

The purpose of this study is to compare the standards and guidelines of long-term care facilities based on the physical environments and human resources in Korea, Japan, USA, and Australia. Ultimately, this study suggests the directions for amendments of long-term care service or running of the facilities in Korea. For achieving this purpose, we reviewed the homepage of national health departments, reports and articles of long-term care service, and acts related with long-term care in each country. This comparisons were carried in terms of physical environments, human resources by long-term care related acts and legal sanctions as means of quality control. This study implies that long-term care service guidelines or standards should be revised for developing the quality of our long-term care services.

• 대한간호학회지
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• 제33권6호
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• pp.731-742
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• 2003

Purpose: This ethnography is aimed at describing the health care seeking behavior of elderly details in their socio-cultural context. The research question is 'under what conditions did elderly informants decide to use certain professional health care services and how do they make use of all the available resources?' Method: 10 sessions of fieldwork were conducted in the two agricultural villages between Sep. 1999 and Oct. 2002. The data for this paper came from participant observation with 14 informants. In the process of analysis I used proxemic and taxonomic techniques. Result: Informants decided to use a certain health care system according to their folk definition of illness. They prefer to use the health services where they felt more comfortable and free. They wished to be care from intuitive and holistic healers. Social network and having health resources was also important factor. Conclusion: We need more comprehensive research model to reach a plausible explanation. Combined qualitative-quantitative research is needed to get practical data to develop effective health care systems for the elderly.

• 보건교육건강증진학회지
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• 제27권2호
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• pp.37-48
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• 2010

Objectives: In health care setting, patient education and health promotion services are inexpensive and effective initiatives to change health behavior due to use medical service resources and personnel. This study performed to define the responsibilities and competencies of health education specialist in private health care setting. For our suggestion, we reviewed regulatory, recommendation, and programs related to health education and promotion in clinics and hospitals. Results and Conclusion: The health promoting hospital and health services in Europe and innovative hospitals of community health promotion in the U.S. were examples of approaches that supply target groups with health promotion services in health care setting. The National Commission for Health Education Credentialing has suggested the specified responsibilities and competencies of health education specialist in health care setting according to their general duty. Considering the recommendation of the NCHEC, our suggestion included: 1) the three kinds of job scope, 2) the major targets, 3) the specified responsibilities and competencies, and 4) the available health promotion programs in clinic and hospital setting. The suggestion will contribute to the development of job market for health education specialist and to the cooperation with community health resources in health promotion services and comprehensive health care.

• 보건교육건강증진학회지
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• 제32권3호
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• pp.11-22
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• 2015

Objectives: This study was to examine the influences of community characteristics on the mortality rates. Community characteristics included socioeconomic environmental characteristics, health care resources, and health lifestyle practice. Methods: This study used secondary data whose units of analyses were 249 administrative districts. Mortality rates were estimated with hierarchical regression models entered in the order of (1) socioeconomic environmental characteristics, (2) health care resources, and (3) health lifestyle practice. Results: About 70% of mortality rate was explained by socioeconomic environmental characteristics, health care resources, and health lifestyle practice. In particular, socioeconomic environmental characteristics showed the strongest impact on mortality rate. Among socioeconomic characteristics, community with lower rate of households headed with college or more, lower number of inhabitants per on-premise license, higher rate of population in poverty, and rural region showed higher mortality rate. Among health care resources, community with higher number of inhabitants per doctor and lower number of inhabitants per hospital bed showed higher mortality rate. Among health lifestyle practice, community with higher current smoking rate and lower moderate physical activity practice rate showed higher mortality rate. Conclusions: The results suggest that policy makers should take into account socioeconomic environmental characteristics of community in developing community-based health promotion rather than focusing on lifestyle changes of residents.

• Safety and Health at Work
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• 제7권4호
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• pp.354-362
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• 2016

Background: The present study aims at investigating whether and how (1) job demands and job resources are associated with work-to-private-life interference (WLI) and (2) job resources moderate the relationship between job demands and WLI. Methods: Data were collected by a self-report questionnaire from three hospitals in Italy. The sample consisted of 889 health-care workers. Results: All job demands (i.e., quantitative demands, disproportionate patient expectations, and verbal aggression) and job resources (i.e., job autonomy, support from superiors and colleagues, fairness, and organizational support), with the exception of skill discretion, were related to WLI. The effects of quantitative demands on WLI were moderated by support from superiors; fairness and organizational support moderate the effects of all job demands considered. Support from colleagues moderated only verbal aggression. Job autonomy did not buffer any job demands. Conclusion: The present study suggests that the work context has a central importance in relation to the experience of WLI among health-care workers. The results indicated that intervention in the work context may help to contain WLI. Such interventions would especially be aimed at improving the social climate within the unit and quality of the organizational process.

• 지역사회간호학회지
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• 제9권1호
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• pp.163-180
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• 1998

The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.

• Journal of Preventive Medicine and Public Health
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• 제40권6호
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• pp.447-453
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• 2007

Although the New National Health Promotion Plan 2010 target to reduce health inequalities, whether the program will be effective for reducing the health inequalities in Korea remains quite unclear. More and more developed countries have been started to concentrate on comprehensive policies for reducing health inequalities. The health policies of the UK, Netherlands, and Sweden are the most wellknown. I propose that a comprehensive blueprint for tackling health inequalities in Korea should be made and that it must contain five domains: a target, structure and process, life-course approach, area-based approach, and reorganization of health care resources. The target should be based on determinants of health and more attention should be paid to socioeconmic factors. The structure and process require changes from the national health care policy based on medical services to the national health policy that involves the establishment of a Social Deputy?Prime Minister and the strengthening multidisciplinary action. A life-course approach especially focused on the early childhood years. Area-based approach such as the establishment of healthy communities, healthy schools, or healthy work-places which are focused on deprived areas or places is also required. Finally, health care resources should be a greater investment on public resources and strengthening primary care to reduce health inequalities. The policy or intervention studies for tackling health inequalities should be implemented much more in Korea. In addition, it is essential to have political will to encoruage policy action.