• Clinical and Experimental Pediatrics
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• 제60권5호
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• pp.138-144
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• 2017

Purpose: Following legal reform in 2013, the annual number of asylum seekers entering South Korea has increased from 1,143 in 2012 to 5,711 in 2015. We interviewed six African refugee mothers of young children regarding their health needs and barriers to access maternal child health services. Methods: We recruited mothers who had visited a clinic for immigrants between July 2013 and August 2015. Participants were African refugee women, aged over 18 years, who had given birth in Korea within the previous 5 years and had come to Korea over a year before recruitment. Interview questions examined participants' experiences in pregnancy and childbirth and concerns regarding their child's health status. Initial data analysis involved all researchers' immersion in the entire collection of transcripts. We then noted recurrent topics and themes and identified similar issues. Results: At the time of giving birth, 5 participants were asylum seekers and one had undocumented status. The following barriers impeded their access to maternal child healthcare: socioeconomic factors (unstable social identity, low economic status, difficulty obtaining health insurance), language barriers (lack of linguistically appropriate health information, limited access to translation services), and cultural barriers (religious and cultural differences). Weak social support also hindered access to healthcare soon after migration; however, social links with the community emerged as a key coping strategy following settlement. Conclusion: We identified barriers to maternal and child healthcare and coping strategies among African refugee mothers in Korea. Future research should assess refugees' health status and improve health access and literacy among refugee mothers.

• 보건행정학회지
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• 제32권2호
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• pp.237-243
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• 2022

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, four different data which is composed of nationally representative sample of South Korean population were used; the Korea National Health and Nutrition Examination Survey (KNHANES, 2007-2020), the Community Health Survey (CHS, 2008-2020), the Korea Health Panel Survey (KHP, 2011-2018), and the Korean Welfare Panel Study (KOWEPS, 2006-2020). The proportion of individuals reporting unmet healthcare needs were 6.4% (KNHANES), 5.4% (CHS), and 12.2% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.9%, -9.1%, and -5.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.0% (KNHANES), 0.4% (CHS), 2.2% (KHP), and 0.4% (KOWEPS). The APC was -11.3%, -17.0%, -12.2%, and -21.2%, respectively. Overall, the low-income and the elderly population reported a higher rate of unmet health care needs. Although the overall experience rate of unmet medical care due to cost decreased over the past decade, the disparity between the lowest and highest income groups still remained in 2020. Disparity between income levels and age groups is a challenge to address in healthcare system, and these results suggest the need for adequate health coverage for the low-income and the elderly populations.

• Journal of Preventive Medicine and Public Health
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• 제41권2호
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• pp.100-106
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• 2008

Objectives : We measured behavioral factors associated with Koreans receiving gastric cancer screening based on a socio-ecological model, in part to develop strategies to improve cancer screening rates. Methods : A telephone survey was conducted with 2,576 people chosen through stratified random sampling from April 1 - May 31, 2004. Collected information included gastric cancer screening, socio-demographic factors, and socio-ecological factors at intrapersonal, interpersonal, community, and public policy levels. Results : Among 985 survey respondents(380 men and 605 women), 402 had received gastric cancer screening. Logistic analysis was performed to compare those screened and unscreened. 'Age' was the only demographic factor that showed a statistically significant association with getting screening. People in their fifties (OR=1.731, 95% CI=1.190-2.520) and sixties (OR=2.098, 95% CI=1.301-3.385) showed a higher likelihood of getting screened, compared to those in the forties. 'Accessibility to a medical institution' was a significant factor related to having gastric cancer screening at the intrapersonal level. At the interpersonal level, recommendations by family members to be screened and a family practice of routine cancer screening were significantly related. People with frequent education about cancer screening or with stronger social feelings that cancer screening is necessary also demonstrated significantly higher tendencies to be screened. Conclusions : In conclusion, a socio-ecological model seems appropriate for explaining gastric cancer screening behavior and associated factors. Health planners should develop integrated strategies to improve cancer screening rates based on socio-ecological factors, especially at the interpersonal and community levels.

• 보건행정학회지
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• 제31권2호
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• pp.225-231
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• 2021

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, the four different data which is composed of nationally representative sample of South Korean population were used; the Korea Health and Nutrition Examination Survey (KNAHANES, 2007-2019), the Community Health Survey (CHS, 2008-2019), the Korea Health Panel Survey (KHP, 2011-2017), and the Korean Welfare Panel Study (KOWEPS, 2006-2019). The proportion of individuals reporting unmet healthcare needs were 5.8% (KNHANES), 5.3% (CHS), and 11.6% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.5%, -8.0%, and -6.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.1% (KNAHANES), 0.7% (CHS), 2.4% (KHP), and 0.4% (KOWEPS). The APC was -10.5%, -14.2%, -12.2%, and -19.6%, respectively. Compared to last year, the rate of unmet healthcare needs has declined in general. However, the low-income and the elderly population were reporting the highest rate of unmet health care needs, and the disparity between lowest and highest groups were remained. These results suggest that adequate benefit coverage is needed for low-income and elderly population.

• 보건행정학회지
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• 제33권1호
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• pp.107-113
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• 2023

Unmet healthcare is an important indicator for measuring accessibility of healthcare services. We analyzed the following four data from a nationally representative sample of South Korean population: Korea Health and Nutrition Examination Survey (KNHANES, 2007-2021), Community Health Survey (CHS, 2008-2021), Korea Health Panel Survey (KHP, 2011-2019), and Korean Welfare Panel Study (KOWEPS, 2006-2021). The proportion of individuals reporting unmet healthcare needs were 6.0% (KNHANES), 5.1% (CHS), and 13.1% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.4%, -9.4%, and -5.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.2% (KNAHANES), 0.5% (CHS), 2.7% (KHP), and 0.4% (KOWEPS). The APC was -10.4%, -16.1%, -11.5%, and -19.1%, respectively. Compared to the previous year, the rate of unmet healthcare needs decreased slightly, but the rate of unmet health care needs due to cost tended to increase. Overall, higher rates of unmet healthcare needs were reported in the low-income and the elderly population. Although it was confirmed through the APC that the rate of unmet healthcare experience has decreased over the past decade, it can be seen that there is still a disparity by income level and age. These results suggest the need for an appropriate health benefit coverage policy for the low-income and the elderly.

• 한국노년학
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• 제31권2호
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• pp.371-380
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• 2011

본 연구는 노인장기요양보험제도 도입 전후 의료기관 가정간호사업소 수 및 이용량 변화를 파악하고자 하였다. 건강보험심사평가원으로부터 노인장기요양보험제도 도입 직전 1년(2007.7.1~2008.6.30)과 제도도입 후 혼란기인 6개월 후 1년(2009.1.1-12.30)간 의료기관 가정간호 기본방문료(AN100)가 청구된 자료를 받아 분석하였다. 노인장기요양보험제도 도입 후, 약 40개 의료기관 가정간호사업소가 문을 닫았고, 사업소가 한 곳도 없는 시군구가 전체 시군구 중 53%에서 59%로 증가하였다. 또한, 노인의 의료기관 가정간호 이용은 물론(이용자수 13.4% 감소, 방문건수 20.9% 감소), 비노인의 이용도 감소하였다(이용자수 3.5% 감소, 방문건수 3.9% 감소). 비노인의 가정간호 이용감소는 가정방문 간호사업소의 감소로 가정간호에 대한 접근이 낮아져 나타난 결과로 유추할 수 있다. 가정간호사업소 당 총 수입액은 2009년 1년간 평균 121,850천원으로 최소 인력인 가정전문간호사 2인의 인건비를 감안하면 수익이 크지 않은 것으로 확인되었다. 이 연구결과를 통해 노인의 의료기관 가정 간호 이용감소는 노인장기요양보험 방문간호로 대체된다고 하더라도, 비노인의 가정간호 접근성을 높이기 위해서는 의료기관 가정간호사업소를 확대할 필요가 있다.

• 한국치위생학회지
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• 제19권1호
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• pp.117-129
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• 2019

Objectives: The purpose of this study was to investigate the influence of demographic characteristics and oral health status on unmet dental needs among preschool children and to provide a basis for improvement of the dental care equality and accessibility using data from the $6^{th}$ National Health and Nutrition Survey. Methods: This study was performed using data collected from the $6^{th}$ National Health and Nutrition Survey. The subjects were 1,472 out of 22,940 people, who participated in the survey and under went oral examination. IBM SPSS Statistics (Version 20.0) was used for statistical analyses based on the complex sampling design. Frequency analysis was performed to determine the distribution of unmet dental needs according to the characteristics of the subjects. The Rao-Scott ${\chi}^2$ test was performed to examine the relationship of unmet dental needs with general characteristics and health- and oral health-related variables. Relevant factors were determined using binary logistic regression analysis. Results: The factors that had statistically significant relations with unmet dental needs included age, medical insurance, household income, limited physical activity, history of dental caries in deciduous teeth, and subjective health status. Logistic regression analysis of complex samples was conducted to determine factors related to unmet dental needs. The results of analysis showed that limited physical activity and history of dental caries in deciduous teeth were related to unmet dental needs. Conclusions: The results show the factors affecting, and the reasons for, the unmet dental needs of preschool children. Future studies are needed to develop national projects and oral health education reforms to address inequalities in preschool children's dental care.

• Architectural research
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• 제9권1호
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• pp.9-18
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• 2007

The objective of this research study was twofold; 1) to explore and identify health supportive design factors in Swedish elderly care homes and 2) to understand their usefulness and suggest implication in Korean elderly care settings. A descriptive and explorative method was applied using a combination of field studies and semi-structured interviews. Three study trips were carried out during Sept. $14^{th}$ and Oct. $12^{th}$ 2005; two facilities situated in Stockholm suburbs and one in the south of Sweden. According to this research, the valuable factors to support health and well-being for the elderly are as follows; 1) Community integration: These elderly care homes are generally places close to a residential area center or a city center. Services are often shared between residents and community members at large, consequently there is a flow of "visitors" of all ages connecting with the facility on a daily basis. 2) Homelike environment: A noteworthy aspect of Swedish elderly care homes is keeping the facility appearance as homelike as possible. The associations with home may be explored through the appearance and configuration of both the exterior and interior of the building. These homes seemed to be designed with a conscious aim to create a homelike setting. 3) Small scale approach: Clustering of resident rooms is one method through which the small scale approach can be achieved in larger facilities. With unit clusters, the facility can foster opportunities for social interactions among resident. 4) Accessibility to garden and nature: The courtyard is a well developed concept in planning elderly care homes in Sweden. They are generally safe and easily accessible to the residents. Studying Swedish models may provide practical knowledge of how the physical setting may improve resident's health in Korean elderly care homes.

• Journal of Preventive Medicine and Public Health
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• 제52권6호
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• pp.355-365
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• 2019

Objectives: In rural areas of Korea, where public transportation infrastructure is lacking and alternative systems are poor, the elderly experience inconveniences in using healthcare, although their need is high. This study aimed to analyze the association between the convenience of transportation and unmet healthcare needs among the rural elderly. Methods: The data used were collected in the 2016 Community Health Survey among rural elderly individuals aged 65 or older. Dependent variable was the unmet healthcare needs, explanatory variable was the convenience of transportation. The elderly were divided into 3 groups: with no driver in the household, with a driver, and the elderly individual was the driver (the self-driving group). Covariates were classified into predisposing, enabling, and need factors. They included gender, age, education, income, economic activity, household type, motor ability, subjective health level, number of chronic diseases, anxiety/depression, and pain/discomfort. The data were analyzed using logistic regression and stratification. Results: A significant association was found between the convenience of transportation and unmet healthcare needs. When examined unadjusted odds ratio of the group with a driver in the household, using the group with no driver as a reference, was 0.61 (95% confidence interval [CI], 0.54 to 0.68), while that of the self-driving group was 0.34 (95% CI, 0.30 to 0.38). The odds ratios adjusted for all factors were 0.69 (95% CI, 0.59 to 0.80) and 0.79 (95% CI, 0.67 to 0.91). Conclusions: We confirmed a significant association between inconvenient transportation and unmet healthcare needs among the rural elderly even after adjustment for existing known factors. This implies that policies aimed at improving healthcare accessibility must consider the means of transportation available.

• Healthcare Informatics Research
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• 제24권4호
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• pp.263-275
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• 2018

Objectives: Automated audiometry provides an opportunity to do audiometry when there is no direct access to a clinical audiologist. This approach will help to use hearing services and resources efficiently. The purpose of this study was to review studies related to automated audiometry by focusing on the implementation of an audiometer, the use of transducers and evaluation methods. Methods: This review study was conducted in 2017. The papers related to the design and implementation of automated audiometry were searched in the following databases: Science Direct, Web of Science, PubMed, and Scopus. The time frame for the papers was between January 1, 2010 and August 31, 2017. Initially, 143 papers were found, and after screening, the number of papers was reduced to 16. Results: The findings showed that the implementation methods were categorized into the use of software (7 papers), hardware (3 papers) and smartphones/tablets (6 papers). The used transducers were a variety of earphones and bone vibrators. Different evaluation methods were used to evaluate the accuracy and the reliability of the diagnoses. However, in most studies, no significant difference was found between automated and traditional audiometry. Conclusions: It seems that automated audiometry produces the same results compared with traditional audiometry. However, the main advantages of this method; namely, saving costs and increased accessibility to hearing services, can lead to a faster diagnosis of hearing impairment, especially in poor areas.