• 농촌의학ㆍ지역보건
• /
• 제25권2호
• /
• pp.413-425
• /
• 2000

1. 도시지역과 농촌지역의 특성과 각 주민들의 요구를 고려한 서비스를 제공하여야 한다. 도시지역 주민의 경우 보건소의 업무 중에서 질병예방이 우선이라고 하였으며 농촌지역 주민들의 진료 서비스가 우선이라고 하였다(부표 1 참조). 2. 보건소의 역할에 대한 중요성을 재인식할 뿐만 아니라 지역사회 정보화에 맞추어 지역의료체계의 핵심적인 중추기관으로서의 기능을 재정립해야 한다. 따라서 순천시 역시 주민의 보건소에 대한 의존도가 상당히 높다는 것을 감안하여 보건소에서 지역주민이 원하는 정보화 서비스를 구체적으로 파악하여 지역보건의료 서비스의 정보화에 관련된 계획을 수립하는데 이 연구의 결과를 기초로 삼아야 한다(부표 2와 부표 3 참조).

• 보건의료산업학회지
• /
• 제13권1호
• /
• pp.15-30
• /
• 2019

Objectives: This study aimed to analyze people's accessibility to medical institutions providing national gastric cancer screening services in Gangwon-do using a geographic information system(GIS). Methods: To assess the spatial accessibility, network analysis was applied. Two types of network analysis-Service area analysis and origin-destination cost matrix(OD-cost matrix)-were applied to create network dataset. Results: The results of the analysis of the service area revealed that it took more than 60 minutes each to reach tertiary hospitals and general hospitals from 74.4% and 9.6% of Gangwon-do areas, respectively. Similarly, it took more than 60 minutes each to reach hospitals and clinics from 4.2% and 3.4% of Gangwon-do areas, respectively. The results of the OD-cost revealed that there were large regional variations in distance and time taken to reach the medical institutions. Conclusions: there were regional variations of spatial accessibility between Si and Gun in Gangwon-do.

• 지역사회간호학회지
• /
• 제30권2호
• /
• pp.234-242
• /
• 2019

Purpose: This study tries to comprehend older adults' perspectives of community supports and health services in a South Korean city and identify important sociodemographic and health characteristics that affect their perspectives. Methods: 166 older adults were involved in this cross-sectional study. Questions on background characteristics and community supports and health services criteria (categorized as service accessibility, offer of services, voluntary support, or emergency care planning) based upon the WHO's Age-Friendly Cities Guide were used. The data were analyzed using paired and independent t-tests, one-way ANOVA, and hierarchical multiple regression analyses. Results: emergency care planning was rated as the most important by the participants (mean age=76.24 years, 22.9% male), while its current level of performance was lowly appraised (p<.001). The rated importance for each category differed based on individual characteristics. Depression (p=.016), older age (p=.012), and restricted network type (p=.039) were significantly related to ascribing a higher degree of importance to community services. Conclusion: Community initiatives are warranted to optimize emergency care for older adults. This planning must be based on the unique characteristics of older adults in coordination with supportive resources. In addition, comprehensive assessments are warranted before implementing action plans to ensure that the multi-dimensional problems of older adults are incorporated.

• 보건행정학회지
• /
• 제31권1호
• /
• pp.125-139
• /
• 2021

Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion: This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

• 지역사회간호학회지
• /
• 제20권4호
• /
• pp.443-452
• /
• 2009

Purpose: The purpose of this study were to examine the need of community care services and the influencing factors of the need in the family care givers of hospital-based home care patients. Methods: Data were collected from 256 family caregivers, who were recruited from 10 hospitals in a metropolitan city. A structured questionnaire on the characteristics of caregivers, resources, and patients was administered. Also, questions on the need of community care services were added. Logistic regression analysis was used to identify the influencing factors of the need for community care services. Results: The participant needed more transportation service, lease of health care devices, visiting bath, caring, visiting hair dressing than that of housekeeping, short-term care, and day care service. Various variables from the three factors were found to be influenced on the need of community care services. Conclusion: The accessibility of the higher need of community care services should be increased for hospital-based home care users. Also, the factors of Family care giver, Resource, and Patient might be considered to provide community care services of hospital-based home care users.

• 한국간호교육학회지
• /
• 제15권1호
• /
• pp.89-99
• /
• 2009

Purpose: The purpose of this study was to describe married female migrants' experiences of health care services and to help nursing researchers, nursing educators, and clinical nurses understand married female migrants' experiences. Method: A conventional content analysis method was utilized. Individual in-depth interviews with 15 married female migrants were conducted. Subject recruitment was performed at a district in Seoul. Results: Ten categories were induced: language barrier, financial burden, insufficient time with a physician, complexity of utilization process, lack of support from peer group, health care providers' discrimination, anxiety regarding lack of information about children's health, health care providers' concerns and efforts to minimize the language barrier, family support, and advanced health care service environment. Conclusion: This study provides basic knowledge regarding married female migrants' experiences related to health care services. Future research should designate and utilize valid instruments to measure the positive and negative experiences and to explore strategies to strengthen the positive features while eliminating the negative ones. Finally, the Korean nursing education curriculum should include cultural competence and knowledge about an ethnic minority's right to health service utilization.

• Journal of Preventive Medicine and Public Health
• /
• 제17권1호
• /
• pp.121-126
• /
• 1984

Several detailed aspects of medical care services during one year (Aug 1, $1982{\sim}$July 31, 1983) were compared between two community health sub-centers; one (A) was served by a local clinician, the other (B) by a trainee of preventive medicine. The results were analysed as follows: 1. Total spells of medical services during the same period in 'A' sub-center was 4,087 and that in 'B' 2,347. Medicaid visitors in 'A' was 1,051 (25.7% of the total), that in 'B' was 250 (10.7%). Significant difference was observed. 2. Average number of visits for the same case in 'A' was 2.0, that in 'B' was 1.4. Average duration of service by day for the same case in 'A' was 3.9, that in 'B' 3.0. 3. Average cost of service for a case in 'A' was 6,770 won, that in 'B' 4,230 won. 4. Difference in age distribution of visitors in the two sub-centers was insignificant. $0{\sim}9$ year group was 38.5% of the total. Difference in distribution by sex (between two sub-centers) was minimal. Male utilisers more than female by ca. 10%. 5. Concerning distribution of visitors by month, utilisation in July, August and September was the highest; the sum of them was 32.7% of the total in 'A' and 32.9% in 'B'. 6. Distribution by diagnoses in 'A' in decreasing order of frequency was Respiratory system diseases (26.1%), Digestive system diseases (23.0%), Diseases of skin and subcutaneous tissue (17.4%), Accidents and poisoning (11.5%) and Diseases of musculoskeletal system and connective tissue (5.4%). That in 'B' was Respiratory system diseases (39.0%), Digestive system diseases (23.0%), Diseases of skin and subcutaneous tissue (14.2%), Accidents and poisoning (10.9%) and Infection and parasitic diseases (9.1%). 7. The 10 most frequent diagnoses comprised 68.5% of the total in 'A' and 65.5% in 'B' 8. Utilisation by accessibility to each sub-center was studied. It is shown that the nearer the distance or the easier the accessibility, the more visits to services. The distinct pattern is manifested in the utilisation in 'A'-Myun.

• 보건교육건강증진학회지
• /
• 제12권1호
• /
• pp.22-46
• /
• 1995

This is an effort to project health care resources in need for the elderly in the future when advanced transportation systems would greatly reduce geographical accessibility to health care services for the rural elderly. Two areas, Kimhae and Chuncheon, were selected for the study. Projection of health professionals and health care institutions for the elderly were made based on the analysis for the morbidity and illness behavior reported to two data sources, National Survey for the Elderly in 1992 by Korea Institute for Health and Social Affairs and beneficiary data by Korea Medical Insurance Cooperation for those living in the study areas in 1992. Projected number of health professionals and health care institutions were estimated for each area under study in years of 2010 and 2030, with those in a Japanese being used as a standard. Policy implications were discussed.

• 보건행정학회지
• /
• 제30권1호
• /
• pp.131-138
• /
• 2020

The purpose of this study was to compare the health status of South Korea with those of Organization for Economic Cooperation and Development (OECD) countries and examine the trends. Position vAlue for Relative Comparison (PARC) was used as a gauge for comparison, and five sectors of the health care system were measured: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used as a statistical analysis method to examine trend of PARC values obtained from 2000 to recent years. According to the results, the demand, supply, accessibility, and quality sectors were higher than the OECD average, while the cost was lower than the average. However, there is a recent trend of sharp increases in health care costs. Some indicators: health employment, quality of primary care and mental health care were lower than the OECD average, and health determinants showed a worsening trend. Therefore, policy-makers need to take this into account and make efforts for sustainable health care.

• 보건행정학회지
• /
• 제21권1호
• /
• pp.23-43
• /
• 2011

Access to health care is complicated to define. It is a multidimensional process. In addition to the matters of quality of care, geographical accessibility and availability of the right type of care, finance, and acceptability are all involved. The purposes of this paper are to measure the geographic distances between patient residency locations and health service organizations in which the patients hadvisited, and to investigate the association between geographical distance measures and variables involved in health service utilization. The study used the first and the second wave of the 2008 Korea Health Panel Survey. The samples of analyses were patients who had visited outpatient or used ambulatory health services, and the total observations (visit numbers) analyzed were 229,128. We divided the samples into a frequent-visit illness group (Group 1) and a non-frequent visit illness group (Group 2) based on over 5,000 total visit numbers. We exploited three level analyses using xtmixed of STATA${\Box}$ 11.1 command with/without interaction terms among age, sex, and occupation. Geographical distances were measured using the Haversine method. Group 1 was tended to older and lower equivalent income than those of Group 2, but the geographic difference were not observed in terms of area deprivation index and standard mortality ratios. Amongst group 1, diabetes mellitus patients travelled far to visit health care organizations, and arthritis patients were more deprived in terms of the personal and areal characteristics. The study revealed that residents in rural areas traveled about 10 times more long distances than those whom lived in larger cities after adjusting for various variables, which we used for analyses. This study contributed to the practical understanding of health service utilizations using empirical analyses, and found that the types of diseases and socioeconomic characteristics of patients tended to define the amount of travel distance to healthcare organizations.