• Quality Improvement in Health Care
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• v.25 no.2
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• pp.16-25
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• 2019

Purpose:The healthcare system of South Korea is at the extreme of the dispersed system. Few regulations limit patients from directly visiting higher-level medical institutions for primary care sensitive conditions. As a result, similar to local clinics, general and tertiary teaching hospitals also provide diverse primary care services. Our study aimed to examine the general public's perceptions of their primary care performance. Methods: Face-to-face surveys were conducted with 1000 adults who were living in South Korea with the aid of a questionnaire that included the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of five domains, which are the main indicators of primary care performance: first contact, comprehensiveness, coordination, personalized care, and family/community orientation. One-way analysis of variance and post hoc tests were used to compare the KPCAT scores across the three types of medical institutions. Results: Domain-wise analyses revealed two different patterns. With regard to first contact and its subdomains, the highest and lowest scores emerged for local clinics and tertiary teaching hospitals, respectively. However, the other four domain scores were significantly lower for local clinics than for the other two types of medical institutions. Conclusions: Local clinics were perceived to be medical institutions that are responsible for providing primary care. However, the general public perceived only one domain of their primary care to be superior to that of the other two types of medical institutions: first contact. National efforts should be taken to strengthen their other four domains of primary care by training their workforce and providing appropriate incentives.

• Research in Community and Public Health Nursing
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• v.28 no.2
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• pp.129-143
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• 2017

Purpose: The purpose of this study is to explore factors which influence adoption, implementation and continued use of tele-healthcare systems. Methods: Qualitative research was conducted by in-depth interviews with 17 professionals from various fields of organizations involved in developing and implementing tele-healthcare systems. Data were analysed thematically, using a conceptual model of diffusion of innovations. Results: The system users were reacted positively to the 3 attributes out of 9 which decided the adoption of innovation. In addition, it is required to redesign the tele-health care system simpler and easier so that the system users can access to the system much more easily regardless of space and time limitations. From the design stage on an individual level, it is necessary to conduct detailed needs analysis and listen to users who are at the center of innovation diffusion. On an organizational level, it is necessary to actively prepare for possible problems during system implementation, educate the users and build communication channels continuously. Conclusion: This study has identified the factors affecting the innovation of tele-health care systems and contributed to the understanding of the operation of tele-health care systems by the diffusion of innovation theory in community health posts.

• Journal of Korean Academy of Rural Health Nursing
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• v.4 no.1
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• pp.41-50
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• 2009

By the rural area health care special law in 1980, Primary health care posts were established in rural areas as fundamental elements of the national health system. Nurses have been deployed to the posts after taking an education course mandated by the special law. However, health care posts have confronted environmental changes over the past 30 years such as an aging and decreasing rural population and advanced traffic systems, which make it necessary to reshape their form and role. Therefore, some guidelines are suggested for future role enlargement of health care posts by analyzing their current management and duties. The guidelines are as follows: 1) enlarging the portion of prevention and management of chronic degenerative diseases, 2) development and practice of diverse health promotion programs, 3) extension of primary health care for the increasing older population, 4) development of health programs for married immigrants, 5) practice of timely maternal child health programs, 6) development of adequate health care posts for low-income people in rapidly urbanizing rural areas and in poor areas in big cities, and 7) revision of laws and institutional arrangements for the role enlargement of health care posts to match social changes and customer needs.

• The Journal of Korean Academic Society of Nursing Education
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• v.5 no.1
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• pp.97-105
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• 1999

Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7757-7759
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• 2013

Physicians, in order to study the causes of cancer, detect cancer earlier, prevent or determine the effectiveness of treatment, and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive, and timely cancer data. The cancer care environment has become more complex because of the need for coordination and communication among health care professionals with different skills in a variety of roles and the existence of large amounts of data with various formats. The goals of health care systems in such a complex environment are correct health data management, providing appropriate information needs of users to enhance the integrity and quality of health care, timely access to accurate information and reducing medical errors. These roles in new systems with use of agents efficiently perform well. Because of the potential capability of agent systems to solve complex and dynamic health problems, health care system, in order to gain full advantage of E- health, steps must be taken to make use of this technology. Multi-agent systems have effective roles in health service quality improvement especially in telemedicine, emergency situations and management of chronic diseases such as cancer. In the design and implementation of agent based systems, planning items such as information confidentiality and privacy, architecture, communication standards, ethical and legal aspects, identification opportunities and barriers should be considered. It should be noted that usage of agent systems only with a technical view is associated with many problems such as lack of user acceptance. The aim of this commentary is to survey applications, opportunities and barriers of this new artificial intelligence tool for cancer care information as an approach to improve cancer care management.

• CELLMED
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• v.6 no.2
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• pp.9.1-9.6
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• 2016

Traditional healers in Ghana are so near to the health needs and aspirations of the majority of people who live mostly in the rural areas, yet have been excluded from the formal health care delivery system. Medical systems in Africa and around the globe have broad-ranging ties to the cosmology and the way of life of a people. However, in Ghana, colonialism and external orientation have had a negative influence on Traditional Medicine (TRM). Thus, in Ghana, Traditional healers can be described as a marginalized group and yet their roles in effective delivery of primary and mental health care cannot be overemphasized. This paper elucidates advocacy work toward medical pluralism in Ghana. First, the influence of colonialism on TRM is briefly examined, followed by highlights on advocacy work intended to include TRM in the health care system. Based on "small wins", challenges, successes, and prospects of our advocacy are discussed.

• Journal of Yeungnam Medical Science
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• v.36 no.1
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• pp.1-7
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• 2019

The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.

• Korean Chemical Engineering Research
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• v.57 no.1
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• pp.73-77
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• 2019

Isothermal (vapor + liquid) equilibrium data measurements were undertaken for the binary mixtures of (propylene oxide + 1-pentanol) system at three different temperatures (303.15, 318.15, and 333.15) K. The Peng-Robinson-Stryjek-Vera equation of state (PRSV EOS) was used to correlate the experimental data. The van der Waals one-fluid mixing rule was used for the vapor phase and the Wong-Sandler mixing rule, which incorporates the non-random two liquid (NRTL) model, the universal quasi-chemical (UNIQUAC) model and the Wilson model, was used for the liquid phase. The experimental data were in good agreement with the correlation results.

• Health Policy and Management
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• v.3 no.1
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• pp.25-52
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• 1993

Variation in the utilization of medical services is a very important issue in cost containment and quality assurance of health care. Practice variation directly affects health care expenditure especially in fee-for-service system, which is the payment system of health insurance in Korea. In addition to cost issue it is generally accepted that variations in medical practice and the cost of inpatient care suggest the possibility of inappropriate quality of care. This study is to closely examine the patterne and degrees of variation in cost structure of inpatient care among types of hospital and individual hospitals in some tracer diseases, and also to inquire into the service items which contribute much to the variation of total medical care cost. Foru common diseases, i.e. Cesarean Section, appendectomy, cataract extraction and pediatric pneumonia, were selected as tracer diseases. In most tracer diseases there were statistically significant differences in total medical care cost among hospitals in same type of hospital as well as among types of hospital(p<0.01). When total medical care cost were subdivided into the types of service, cost of medication and diagnostic examination varied the most prominenly. When the cost of medication were subdivided again, cost of parenteral antibiotics showed the most prominent variation. Of total medical care cost, medication was most contributory to the variation of total medical care cost(58.1~82.3%), and cost of antibiotics was most contributory to the variation of medication cost(63.9~92.2%). The results of study implicated that reducing the variation of medication may plays a significant role in containing the cost of inpatient care. In order to sort out the factors affecting practice variations including drug prescription pattes further researches are required.

• Journal of Korean society of Dental Hygiene
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• v.15 no.4
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• pp.565-574
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• 2015

Objectives: The purpose of the study is to investigate the oral health of the elderly people receiving nursing care and home care services in Chungnam. Methods: The subjects were 350 elderly people receiving 21 nursing care and home care services in Chungnam. The direct interview with the elderly people and oral examination was carried out from July, 2012 to December, 2013 after explanation fo the purpose of the study. The subjects consisted of 178 elderly people receiving nursing care services and 172 elderly people receiving home care services. Except incomplete answers, 315 data were analyzed. The questionnaire consisted of general characteristics of the subjects, characteristics by facility, oral condition, oral care behavior, correlation by factors on oral health, influencing factor on dental caries, influencing factor on periodontal disease, and influencing factor on elasticity of gingival muscle. Data were analyzed by frequency analysis, chi-square test, and multiple regression analysis using SPSS 21.0 program. Results: Multivariate analysis of influencing factors on oral health revealed that the elderly people with low education level tended to have higher incidence rate of dental caries. The influencing factors on oral health were the elasticity of gingival muscle, periodontal disease, educational level, and economic level. (p<0.05). The explanation power was 26.2%. Conclusions: Oral Health Promotion should be obligatorily established as one of the medical system and medical fee system to promote oral health condition for the aged.