• Title/Summary/Keyword: health services accessibility

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Mammography Screening Uptake among Female Health Care Workers in Primary Health Care Centers in Palestine - Motivators and Barriers

  • Nazzal, Zaher;Sholi, Hisham;Sholi, Suha;Sholi, Mohammad;Lahaseh, Rawya
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2549-2554
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    • 2016
  • Background: Early detection remains the cornerstone of breast cancer control in terms of outcome and survival. Thus far the only breast cancer screening method proven effective is mammography. The awareness of female health care workers (HCW) about breast cancer prevention is of vital importance, as their beliefs and behavior may have a major impact on other women. This study was designed to assess mammography screening uptake among female healthcare workers at primary healthcare centers, and to identify the primary motivators and barriers that affect uptake results. Materials and Methods: A cross sectional study design was used to assess mammography screening by 299 female healthcare workers who completed a self-administered questionnaire that assessed demographics, screening uptake, motivators and barriers. Results: The mean age was 46 years (within age of risk). The majority (95.1%) demonstrated adequate knowledge about breast cancer and mammography screening and 50% of the participants reported having at least one mammogram; however only 21% of them had regularly scheduled mammograms. The most frequent reported motivator was the perceived benefit that early detection of breast cancer is important for its management (89.6%), followed by the belief that mammography can detect breast cancer before its symptoms appear (84.4%). On the other hand, the most frequent barrier reported was being busy (46.7%), followed by the lack of perceived susceptibility (41.5%). Conclusions: Mammography screening was found to be sub-optimal in a population of HCW's with 50 % stating that they received a mammogram at least once, and a minority reported regular screening. There is a pressing need for educational programs aimed at removing the barriers that limit compliance with recommendations for mammography screening, and to emphasize the importance of early detection in breast cancer treatment. Ensuring the availability and accessibility of screening services, particularly for healthcare workers within their work settings are other important factors that would improve the acceptance and compliance for mammography screening programs.

A Study of the Relationship to the Student's Health Behavior, Belief, Value and Health Service Utilization -With Emphasis on Family Structure and Other Variables- (학생(學生)의 건강행위(健康行爲), 신념(信念), 가치(價値) 및 보건의료(保建醫療) 이용(利用)에 미치는 영향(影響)에 관(關)한 연구 -가족(家族)의 형태(形態) 및 제특성(諸特性)을 중심(中心)으로-)

  • Chung, Yeon Kang
    • Journal of the Korean Society of School Health
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    • v.6 no.1
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    • pp.9-44
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    • 1993
  • An explorative and descriptive study in order to determine the effect of family structure and other socio-demographic variables on health behavior, belief, locus, and value and utilization of public health service was carried out. Data were collected from 1,653 subjects randomly sampled in three areas, Seoul, Kyunggi province, and Cheju province. From Seoul 849 subjects were selected, 397 subjects Kyunggi, and 407 subjects from Cheju, respectively. Self-reporting questionaires were administered during the period from March to June, 1992. The major findings were as follows: 1) The subjects visited herb-doctor's at irregular intervals mainly to have tonic medicine prepared. They preferred herb-doctor's rather than with doctors at clinics and hospitals. Statistically significant difference was found among the regions studied (p<0.05). 2) The reason for visiting hospitals was primarily for treatment of diseases. They preferred hospital because they felt that the hospitals offer much highly reliable treatment services as well as medical accessibility. For the purpose of hospital utilization, statistically significant differences existed among sex, educational level, family type and region. However, no significance was found among sex, educational level, and region (p<0.05). 3) The subjects utilized general hospitals mainly for diagnosis and treatment of diseases. They preferred general hospitals because of their much better facilities and reliability. Statistical significance was found among sex, educational level, and region (p<0.05). 4) The subjects visited dentist at irregular intervals basis. They visited once half a year or three to four months. their purpose of visit was mainly for diagnosis and treatment of diseases. Statistical significance differences were found among educational level, region and economic standard (p<0.05). 5) Whenever their illnesses were mild and the pharmacies was located in nearby they visited to pharmacies. They visited once a month and patient medicines. Statistically significant differences were found among sex, educational level and region (p<0.05). 6) The subjects believed that herb medicine was quite efficacious for treatment of some diseases, particularly by information handed down through time-honored tradition and experience. However, they recognized that the efficacy of folk medicine can vary with type and severity of diseases. Statistical significance was among sex, educational level, region and economic standard (p<0.05). 7) The reason why subjects believed that pray and superstition are effective for treatment of certain type of diseases, particularly in neuropathy, was the belief in God's almighty. Statistically significant differences were found among sex, educational level, regions and economic standard (p<0.05). 8) Most of subjects under same condition preferred western medicine because they believed that it is more scientific and prompts in showing therapeutic effect. Statistical significance was not found in the choice of type of public health service among, regions. But significant differences were found among sex, educational level and region (p<0.05). 9) The subjects looked for pharmacy if they thought the symptom was mild. However, they visited hospitals for chronic disease and general hospitals for emergency treatment. Statistical significances were found among educational level, region and economic standard (p<0.05). 10) Although most of students wanted to have a healthy life as for the component of health standard and value, they think that they are not healthy (p<0.05). As for the health behavior, significant difference was found in the proportion of smoking and drinking between educational level and region (p<0.05). The health locus was affected by educational level, and health behavior was influenced by region, sex and educational level. The utilization of type of public health service was influenced by family type and region, and health belief by region and educational level, and the health values by region and economic standard respectively, most of correlation showed statistical significance. Among them, the highest correlation was seen between locus of control and external/internal locus of control, which is quite obvious. The correlation between health belief and behavior was the next highest, but still low (0.343). All the other variables are low but significant except only a few of those. These findings indicate that health education should be incorporated into the curriculum so as to develop desirable health habit, and ability of self-control in accordance with their growth stages. A systematic and scientific understanding on the herb/folk medicine is needed, and greater reliability of the utilization of public health services are is still required. Health policy for equal distribution of health service throughout the country along the hierarchical health service system and complementary mutual assistance and cooperation among various health organizations are also required.

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Factors Influencing Chinese Customers' Selection of Health Care Service Countries: Focusing on Word-of-Mouth Moderating Effects (중국고객 해외의료관광국가 선택의도에 영향을 미치는 요인에 관한 연구: 구전 조절효과를 중심으로)

  • Zhang, Jun;Lee, Hoon-Young
    • Journal of Distribution Science
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    • v.13 no.12
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    • pp.41-52
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    • 2015
  • Purpose - Given globalization, the new niche market of medical tourism is likely to experience sustainable growth for various reasons, such as aging populations and a shift in the medical consumerism paradigm toward prevention. Importantly, understanding medical customers' behavior is necessary to benefit from a competitive advantage in this industry. The existing research primarily accessed the key factors of medical quality and costs to explain health customers' behavior but is limited in terms of enabling an understanding of the decision process. This limitation exists because, given the intangibility and greater associated risks in the highly professional industry of international medical tourism, most customers lack the knowledge and experience needed to evaluate the central factors-such as the medical competence of health care countries-before purchases. Therefore, they actively search for useful information through various distributions to reduce uncertainty and to make better choices. Interestingly, most of these information channels are associated with word-of-mouth (WOM). However, no evidence is found in the literature to estimate the effect of WOM in the medical tourism field. Thus, this study focuses on WOM to explore its interaction with key medical characteristic factors and the attractiveness of destinations referred to by sources. This study also affects customers' evaluations and, in turn, influences their intention to seek health care services abroad. Research design, data, and methodology - The literature review addressed an interesting research model for estimating the relations among WOM, medical characteristics, attractiveness, and customers' choice intention regarding international health care. In the key economic regions in China, such as Beijing, Shanghai, Jiangsu, Shandong, and Guangdong, 2,500 survey questionnaires were distributed to potential customers of different ages, education, and income levels. A resulting 1,717 (68.68 percent of the original 2,500) usable surveys were obtained for analysis. Moderated regression analysis was used to determine the effects of WOM in the decision process regarding international health care destinations. Results - The results indicate that WOM is a good moderator of the relationships between the factors evaluated by sources and customers. More importantly, the WOM effects reflect the factors of tie strength, credibility, and vividness. The results also reveal that, given the moderating role of WOM, the intention of potential Chinese customers to seek the referred health care country varies according to the medical characteristics of medical competency and reputation as evaluated by customers. In contrast, the travel attractiveness of the attractions, facilities, accessibility, and social environment are critical determinants of destination choice intention. Conclusions - The moderating role of WOM has been confirmed through the international healthcare destination selection process. Medical tourism managers should user WOM as an effective marketing tool for industry development. Specially, marketers should consider the effects of WOM determinants, such as tie strength, credibility, and vividness, to develop an effective strategy. Furthermore, this study estimates the factors that affect customers' selection of medical tourism destinations. Health care managers or policy makers should consider a broad variety of variables that may attract more Chinese customers to international health care.

Thoracic and Cardiovascular Surgeons' Perception of the Concentration of Cardiovascular Operations in Seoul Metropolitan Area's Hospitals

  • Jeong, Hyo Seon;Lee, Kun Sei;Chee, Hyun Keun;Ahn, Hye Mi;Sim, Sung Bo
    • Journal of Chest Surgery
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    • v.49 no.sup1
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    • pp.53-59
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    • 2016
  • Background: The purpose of this study is to evaluate the concentration of cardiovascular surgical procedures in a metropolitan area and investigate the perception of specialists regarding governmental policies to resolve this imbalance. Methods: From March to May 2015, surveys were distributed to members of the Thoracic and Cardiovascular Surgery Association. The final pool of research subjects consisted of 75 respondents. Subjects were queried regarding the concentration of cardiovascular operations in metropolitan areas, alternatives to the imbalance, and governmental policies to resolve the inequalities. Results: Survey participants responded that South Korea needs governmental policies to alleviate the concentration of cardiovascular surgery patients in large metropolitan hospitals. Participants agreed that the freedom to choose medical institutions and improved accessibility to metropolitan hospitals due to advanced transportation systems were some of the causes for the concentration. A majority (98.7%) of respondents thought establishing thoracic and cardiovascular surgery centers in provinces was an appropriate solution to alleviate the concentration. Thoracic and cardiovascular surgery specialists were ranked as the number one group on which to focus development. Conclusion: Developing and carrying out policies to establish thoracic and cardiovascular surgery centers in provinces will alleviate the regional imbalance in available heart surgery services and an overall improvement in cardiovascular disease treatment in South Korea.

Changes in treatment behavior and cost according to the operation of preventive dentistry in university dental hospital (대학치과병원 예방치과운영 전·후의 환자진료행태와 진료비용 변화)

  • Hong, Hyo-Kyoung;Choi, Seong-Woo
    • Journal of Korean society of Dental Hygiene
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    • v.20 no.5
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    • pp.707-716
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    • 2020
  • Objectives: This study aims to provide basic data for high-quality dental services. In addition, we will promote the operation of preventive dentistry that implements preventive measures. It was conducted to study the change of patient's treatment behavior and treatment cost due to the discontinuation of preventive dentistry in university dental hospitals. Methods: This study collected data using the integrated medical information system of the C University Dental Hospital. From September 1, 2017 to August 31, 2019, data were analyzed using frequency, percentage, mean, standard deviation, chi-square test using SPSS version 24.0 statistical program, and T-test. Results: There was a significant difference in the number of preventive dental treatment cases from 58.3% of preventive dental operation periods to 41.7% of preventive dental operation periods. As a result of comparing the medical expenses, the total medical expenses during the preventive dental operation period decreased from 521,308,872 won to 379,724,995 won during the discontinuation period, 141,583,877 won. The number of medical treatments by treatment behavior decreased 3,835 (28.4%) from a total of 13,520 preventive dental operation periods to 9,685. Conclusions: This study is meaningful as the first study to confirm the change in the treatment behavior and the change in the cost of treatment due to the discontinuation of the operation of preventive dentistry at university dental hospitals. In conclusion, it is thought that there is a possibility of the lack of accessibility and the limitation of professional preventive care due to the discontinuation of preventive dentistry.

The Publicness of Public Institutions: Case Study on the Korea Medical Dispute Mediation and Arbitration Agency (공공기관의 공공성 이행 검토: 의료분쟁조정중재원 사례를 중심으로)

  • Yang, Fain
    • Health Policy and Management
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    • v.31 no.3
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    • pp.280-291
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    • 2021
  • Background: Based on the fact that the Korea Medical Dispute Mediation and Arbitration Agency is a public institution established by social demands for medical disputes, this study reviews the publicness of public organization and discusses its policy implications. Methods: Through Moore's strategic triangle, which consists of legitimacy and support, public value and operational capacity, the process of creating public value is examined. For the analysis, case studies were conducted using related literature data from 2012, when the agency was established, to the present. Results: As a result of the analysis, first, the related law examined in the operational capability has been revised dozens of times, but the revised law has its own contradictions and limitations. The human resource system is also being improved, but there is a problem with the fairness and reliability of the arbitration process, especially due to the limitations of the appraiser system. Second, in terms of legitimacy and support, a regional gap occurred despite efforts to improve accessibility through the expansion of the organization. And the arbitration agency failed to reconcile conflicts caused by stakeholders' perception of each other as a trade-off relationship. Third, the public value result shows that, despite many explicit (statistical) achievements, citizens' use of the past dispute resolution means (litigation) has not decreased. Likewise, the perception of value makers (citizens) is important for creating public value as an invisible result, but it has not yet been formally investigated, so the performance can not be recognized. Conclusion: While the organization's efforts for continuous change and improvement are encouraging, it is not perceived as a better means of resolving disputes and improving quality of services. Therefore, it is necessary to reconsider the institutional design centered on value creators.

THE ADDITIONAL POINT SYSTEM OF NATIONAL HEALTH INSURANCE FOR DENTAL TREATMENT IN PATIENTS WITH A SPECIAL HEALTH CARE NEED IN KOREA (한국의 장애인 환자 치과 진료를 위한 국민 건강 보험 가산제도의 종류 및 청구 현황)

  • Kwon, Doyoun;Nam, Okhyung;Kim, Misun;Choi, Sungchul;Kim, Kwangchul;Choi, Jaeyoung;Lee, Hyo-Seol
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.14 no.1
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    • pp.11-16
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    • 2018
  • In order to increase the accessibility of dental care for people with disabilities, National Health Insurance Service has implemented an additional point system of National Dental Insurance for dental treatment of patients with a special health care need (AID). The purpose of this study is to investigate the types and status of AID in Korea using data of the Health Insurance Review and Assessment Service from 2011 to 2017. The basic consultation fee is increased by 9.03 points (713 won) for brain disorder, intellectual disability, mental disability, or autistic disorder. From 2011 to 2015, the number of claims with a basic consultation fee increased from 90,456 to 141,179. Dental treatment and surgical treatment fee is increased by 100% of the defined insurance score for each of the 15 items. During the five years from 2012 to 2016, the number and amount of claims for each item increased steadily. Of the total claims for 5 years, endodontic treatment was highest, with 107,477 cases, followed by 51,641 cases of scaling. There are two types of dental safety observation fee, simple and complex. The simple safety observation fee is 10,370 won per day, and the complex safety observation fee is 20,750 won per day. Dental safety observation fees were charged 34 times in 2015, 14 times in 2016, and 41 times through May 2017. From 2011 to 2017, the number and amount of claims using AID for dental care for people with disabilities increased. However, considering that the number of registered dental users with disability was about 560,000 in 2016, the number of claims using AID is 1-20,000, which is less than 2% of registered dental users with disability. Therefore, it is necessary to expand dental services for people with disabilities including AID.

A Study of Influential Factors on Health Promoting Behaviors of the Elderly: Focusing on Senior Citizens Living in Seoul (노인의 건강증진행위 영향요인에 관한 연구: 서울지역 거주노인을 중심으로)

  • Kim, Hyesook;Junsoo, Hur
    • 한국노년학
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    • v.30 no.4
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    • pp.1129-1143
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    • 2010
  • The purposes of this study were to investigate the major determinants influencing on health promoting behaviors(HPB) of the elderly living in Seoul. The conceptual framework of the study was Pender's health promoting model and the ecological perspectives. The study was conducted with 495 elderly persons whom 60 years old. For the analysis of data, descriptive statistics and hierarchical regression were used for the statistical analysis with SPSS program. The results were as following: 1) The mean score of the HPB was 3.11(SD=0.41). 2) Hierarchical regression analysis found that ModelIV accounted for 55.7% of the variance in HPB. 3) The Major determinants on HPB among the elderly persons were prior related perceived benefits of action, social support, perceived self-efficacy, community environment, perceived health status, education, and age. In conclusions, first, we should develop to various levels of educational and supportive programs for the HPB among the elderly persons. Second, we should examine more with environment, the accessibility to senior welfare agencies. Third, we should be organized the self-help groups for the elderly persons to improve health promoting behaviors. Fourth, the government should established more secure environment for the HPB, and find better solutions that are provided by various social welfare agencies connected with the coordination of the services in the local communities. Finally, we should develop professional education training programs of the HPB for the practitioners in the field of Gerontological Social Work.

Association between single-person households in the elderly and unmet medical need (고령층 1인 가구 여부와 미충족의료의 연관성)

  • Bon Hee Gu;Min Soo kim;Hyeon Ji Lee;Jae Hyun Kim
    • Korea Journal of Hospital Management
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    • v.29 no.1
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    • pp.46-55
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    • 2024
  • Objective: This study was conducted to provide basic data for the establishment of effective health policies for the unmet medical experience that may occur among the elderly depending on whether they live in a singleperson household or not. Methodology: This study used data from the 8th National Health and Nutrition Examination Survey (2019-2020) and excluded cases with missing values in variables for the total number of respondent participants of 15,469. Finally, 2,850 subjects aged 65 or older were selected for final analysis. This study examined the relationship between experiences of unmet medical needs, attempting to confirm the relationship between single-person households and unmet medical needs through subgroup analysis considering gender, age, and household income. Results: According to the results, in the case of single-person households, the odds ratio (OR) for unmet medical needs was significantly higher at 1.60 times (95% CI: 1.16-2.21). Upon conducting subgroup analyses for gender, age, and household income quintiles, the OR was significantly higher at 2.24 times (95% CI: 1.14-4.41) for males and 1.48 times (95% CI: 1.02-2.14) for females, statistically significant in both cases. For individuals aged 65-69, the OR was significantly higher at 1.90 times (95% CI: 1.04-3.47), but for those aged 70-74 and over 75, it was not statistically significant. In the case of households with 'low' income, the OR was higher at 1.62 times (95% CI: 1.16-2.26), and for 'middle' income, it was significantly higher at 3.21 times (95% CI: 1.08-9.51). Conclusion: This study confirmed that the experience of unmet medical care is high among men who make up single-person households and low-income seniors. Therefore, this study suggests that policies to expand medical services and support welfare for single-person households should be established to resolve these problems, showing that health policies that take into account individual and regional characteristics are needed to improve medical accessibility for single-person households.

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Study of the Residential Environment and Accessibility of Rehabilitation for Patients with Cerebral Palsy (뇌성마비 환자의 주거 환경과 재활 접근성에 관한 연구)

  • Cho, Gyeong Hee;Chung, Chin Youb;Lee, Kyoung Min;Sung, Ki Hyuk;Cho, Byung Chae;Park, Moon Seok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.309-316
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    • 2019
  • Purpose: This study examined the residential environment and accessibility of rehabilitation for cerebral palsy (CP) to identify the problems with residential laws pertaining to the disabled and provide basic data on the health legislation for the rights of the disabled. Materials and Methods: The literature was searched using three keywords: residence, rehabilitation, and accessibility. Two items were selected: residential environment and rehabilitation accessibility. The questionnaire included 51 items; 24 were scored using a Likert scale and 27 were in the form of multiple-choice questions. Results: This study included 100 subjects, of which 93 lived at home and seven lived in a facility. Of these 93 subjects, 65% were living in apartments, usually two or more floors above ground, and 40% of them were living without elevators. According to the Gross Motor Function Classification System, subjects with I to III belonged to the ambulatory group and IV, V were in the non-ambulatory group. Subjects from both groups who lived at home found it most difficult to visit the rehabilitation center by themselves. In contrast, among those who lived at the facility, the ambulatory group found it most difficult to leave the facility alone, while the non-ambulatory group found it most difficult to use the toilet alone. Moreover, 83% of respondents thought that rehabilitation was necessary for CP. On the other hand, 33% are receiving rehabilitation services. Rehabilitation was performed for an average of 3.6 sessions per week, 39 minutes per session. Conclusion: There is no law that ensures secure and convenient access of CP to higher levels. Laws on access routes to enter rooms are insufficient. The disabled people's law and the disabled person's health law will be implemented in December 2017. It is necessary to enact laws that actually reflect the difficulties of people with disabilities. Based on the results of this study, an investigation of the housing and rehabilitation of patients with CP through a large-scale questionnaire will necessary.