• Journal of Preventive Medicine and Public Health
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• v.48 no.5
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• pp.257-263
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• 2015

Objectives: Although the prevalence of depressive disorders in South Korea's general population is known, no reports on the prevalence of depression among patients who visit primary care facilities have been published. This preliminary study was conducted to identify the prevalence of depressive disorder in patients that visit two primary care facilities. Methods: Among 231 consecutive eligible patients who visited two primary care settings, 184 patients consented to a diagnostic interview for depression by psychiatrists following the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. There were no significant differences in sociodemographic characteristics such as gender, age, or level of education between the groups that consented and declined the diagnostic examination. The prevalence of depressive disorder and the proportion of newly diagnosed patients among depressive disorder patients were calculated. Results: The prevalence of depressive disorder of patients in the two primary care facilities was 14.1% (95% confidence interval [CI], 9.1 to 19.2), with major depressive disorder 5.4% (95% CI, 2.1 to 8.7), dysthymia 1.1% (95% CI, 0.0 to 2.6), and depressive disorder, not otherwise specified 7.6% (95% CI, 3.7 to 11.5). Among the 26 patients with depressive disorder, 19 patients were newly diagnosed. Conclusions: As compared to the general population, a higher prevalence of depressive disorders was observed among patients at two primary care facilities. Further study is needed with larger samples to inform the development of a primary care setting-based depression screening, management, and referral system to increase the efficiency of limited health care resources.

• 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.

• Journal of Korean Academy of Nursing
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• v.18 no.2
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• pp.153-161
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• 1988

The purpose of this study was to analyze the level of the services provision of community health practitioners (CHP) and to find out the influence factors on the services provision of CHP. In this study the dependent variables were the level of community health services(CHS), maternal and child health services(MCH), family planning services(FPS), primary care services(PCS) and the ratios of preventive health services(PHS). And independent variables were predisposing, community demographic and task factors. For this analysis, atepwise regression was used. Data collected for the study on reorganization of health centers organization in 1985 was partly used. The findings of this study can be summarized as follows : First, total variance of independent variables for CHS, MCH, FPS, PCS and PHS are shown 62.5 percent, 58.3 percent, 41.8 percent, 17 percent and 61.9 percent respectively. Second, the most important variables which explain CHS, MCH, FPS, PCS and PHS was ratios of household contacted ($R^2$＝0.289), marital status ($R^2$＝0.177), marital status($R^2$＝0.167), ratios of household contacted($R^2$＝0.119) and management of preventive health services($R^2$＝=0.203) respectively. The independent varivbles used in this analysis presented that the explnining for the provision of preventive health service are more influenced than primary care services. In summary this analysis suggests that the level of preventive health services provision of CHP is low and the provision of primary care services compared with preventive health services are occurred independentely. In the future, the strategies for active preventive services by CHP must to be strengthened.

• Journal of Preventive Medicine and Public Health
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• v.56 no.3
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• pp.248-254
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• 2023

Objectives: Measuring the quality of care is paramount to inform policies for healthcare services. Nevertheless, little is known about the quality of primary care and acute care provided in Korea. This study investigated trends in the quality of primary care and acute care. Methods: Case-fatality rates and avoidable hospitalization rates were used as performance indicators to assess the quality of primary care and acute care. Admission data for the period 2008 to 2020 were extracted from the National Health Insurance Claims Database. Case-fatality rates and avoidable hospitalization rates were standardized by age and sex to adjust for patients' characteristics over time, and significant changes in the rates were identified by joinpoint regression. Results: The average annual percent change in age-/sex-standardized case-fatality rates for acute myocardial infarction was -2.3% (95% confidence interval, -4.6 to 0.0). For hemorrhagic and ischemic stroke, the age-/sex-standardized case-fatality rates were 21.8% and 5.9%, respectively in 2020; these rates decreased since 2008 (27.1 and 8.7%, respectively). The average annual percent change in age-/sex-standardized avoidable hospitalization rates ranged from -9.4% to -3.0%, with statistically significant changes between 2008 and 2020. In 2020, the avoidable hospitalization rates decreased considerably compared with the 2019 rate because of the coronavirus disease 2019 pandemic. Conclusions: The avoidable hospitalization rates and case-fatality rates decreased overall during the past decade, but they were relatively high compared with other countries. Strengthening primary care is an essential requirement to improve patient health outcomes in the rapidly aging Korean population.

• Journal of Society of Preventive Korean Medicine
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• v.17 no.2
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• pp.69-78
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• 2013

Objectives : Health cooperative movement is of increasing concern among medical consumers and professionals in Korea. Most health cooperative clinics provide Western Medicine and Korean Medicine(KM) to patients. This study aimed to evaluate the primary care level of health cooperative KM clinics and compare it with local KM clinics in Korea. Methods : Face to face survey was performed at the 3 health cooperative KM clinics and 5 local KM clinics with the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of 5 domains (21 items): first contact (5), coordination function (3), comprehensiveness (4), family/community orientation (4), and personalized care (5). Subjects were patients or guardians who had visited KM clinics five times or more during the last 3 months. We compared primary care scores of each domain between health cooperative KM clinics and local KM clinics. Results : Data were collected from 200 respondents (100 patients from health cooperative KM clinics and 100 local KM clinics). Total average scores of the KPCAT for health cooperative clinics and local KM clinics were $81.1{\pm}12.0$ and $75.4{\pm}9.5$, respectively. Among primary care domains, personalized care was the highest ($89.2{\pm}12.0$, $89.6{\pm}8.4$, respectively), and comprehensiveness function was the lowest ($68.5{\pm}22.5$, $54.5{\pm}22.0$, respectively). Significant differences between two groups were noted in comprehensiveness function (68.5 vs. 54.5, P=0.000), family-community orientation (79.5 vs. 73.0, P=0.004), first contact(89.2 vs 84.0, p=0.001) and coordination function(74.0 vs 68.7, p=0.025). Conclusions : Based on the patients assessment, health cooperative KM clinics provide more primary care-oriented services than local KM clinics. This means that health cooperative clinic can be one of alternatives to strengthen the primary health care in Korea. Future researches are recommended to measure patients satisfaction and treatment effectiveness in the health cooperative clinics.

• Journal of Korean Academy of Rural Health Nursing
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• v.1 no.1
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• pp.5-10
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• 2006

Purpose: This study was done to identify strategies for the reform of the primary health care delivery system in rural areas. Methods: Official documents on changes in the rural health care environment were reviewed along with previous articles on reform of the health care delivery system in rural areas. Results: The primary health care system in rural areas of South Korea has not been well developed by the government. The government has mainly invested in hardware like facilities and equipment but, not in software like the delivery system or personnel. Nowadays every country is confronted with an aging society, which means an increase in the prevalence of chronic disease. Thus they have again become interested in primary health care delivery system. Further, characteristics of the primary health care system have changed to be more comprehensive and to focus on chronic disease. The primary health care system in rural areas should have basic health care functions and a visiting medical officer(doctor) connected with basic health care. Conclusions: The primary health care delivery system is the best strategy when adjusted to the characteristic of the chronic diseases that are prevalent today. Cooperation of the central government and local government is important if these changes are to be realized.

• Journal of Korean Academy of Rural Health Nursing
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• v.3 no.2
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• pp.75-80
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• 2008

This profile presents a brief overview of the past and current primary health care of Saje PHCP in Wonju Si, Kangwon-Do, Korea. Because of the increasing in the proportion of the elderly in the population and the vulnerability among groups, they are one of the main targets of the PHC through programs such as chronic disease management, health promotion activities (exercise, diet, smoking and alcohol control). Curative services have been decreased and preventive services have been increased.

• Journal of the Korean Society of School Health
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• v.17 no.2
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• pp.11-22
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• 2004

Purpose: The aim of this study was to evaluate the effects of oral health care programs in 3 school-based oral health care center among primary schoolchildren. Methods: School-based oral health care programs included fluoride mouth rinsing, pit and fissure sealing for permanent premolars and molars, fluoride gel application and chewing of xylitol candy. All of the programs were carried out by one dental hygienist among 'D' primary schoolchildren in Daegu city under the supervision of a dentist. Baseline dental examinations were completed and preventive care was implemented for 544 children during one year. All of the children visited a school-based oral health care center every three months for a regular check-up. The final oral examination was conducted from March 15 to April 1, 2004. The data analysis data was made on the basis of SAS 8.01. Mean differences between 2003 and 2004 data were compared by paired t-test. Corresponding p-values were considered significant at values less than 0.05. Results: The DMF rate and DFT index were reduced to 8.0% and 8.4% during one year respectively, but there were no statistically significant differences. The DMF rate was significantly reduced (16.3%) after a one year program of school-based oral health care practice. The DMFT(Decay Missing Filling Tooth) index was also reduced compared to 2003 throughout the entire grade. Conclusion: School-based oral health care programs can reduce the prevalence of dental caries prevalence among schoolchildren during one year. This program also improved the oral health capacity of schoolchildren. It is recommend that the school-based oral health care program should be extended to every primary school in Korea.

• Health Policy and Management
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• v.24 no.1
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• pp.100-106
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• 2014

Background: There is no consensus on the definition of primary care in South Korea. This study's objective was to define the concept of primary care using a Delphi method. Methods: Three expert panels were formed, consisting of 16 primary care policy researchers, 45 stakeholders, and 16 primary care physicians. Three rounds of voting, using 9-point appropriateness scales, were conducted. The first round involved rating the appropriateness of 20 previously established attributes of primary care. In the second round, panelists received a summary of the first-round results and were asked to once again vote on the 10 undetermined attributes and the provisional definition. The final round involved voting on the appropriateness of the revised definition. The Korean Language Society reviewed the revised definition. Results: Four core (first-contact care, comprehensiveness, coordination, and longitudinality) and three ancillary (personalized care, family and community context, and community base) attributes were selected. The Korean definition of primary care was accomplished with all three panel groups arriving at a 'very good' level of consensus. Conclusion: The Korean definition of primary care will provide a framework for evaluating performance of primary care in South Korea. It will also contribute to resolving confusion about the concept of primary care.

• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.271-273
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• 2015

Quaternary prevention should be implemented to minimize harm to patients because the ultimate goal of medicine is to prevent disease and promote health. Primary care physicians have a major responsibility in quaternary prevention, and the establishment of clinical epidemiology as a distinct field of study would create a role charged with minimizing patient harm arising from over-medicalization.