• Journal of Oriental Neuropsychiatry
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• v.34 no.4
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• pp.359-368
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• 2023

Objectives: This study aims to establish a Korean medicine doctor's range of services in the dementia relief primary care system based on the previously developed dementia clinical practice guidelines (CPGs). Developing a dementia relief primary care Clinical Pathway (CP) can aid clinically when the Korean medicine primary care doctor conducts treatment. Methods: We analyzed Dementia Korean Medicine Primary Care Model Data and then applied CP Methodology to develop the configuration of the Korean Medicine Primary Care Model. For patients with Alzheimer's dementia (AD), vascular dementia (VD), and mild cognitive impairment (MCI), the Korean Medicine Primary Care Model focuses on improving cognitive function, everyday living abilities and easing symptoms through interventions described in CPGs. The contents of the draft model later include references to already-existing CPs. Results: The study sites were chosen as Korean medical clinics connected to primary care physicians in the dementia-friendly model. The CP used a time task matrix version to arrange the clinical chronology, which included all examinations, diagnoses, and treatment procedures, from the initial appointment to follow-ups and the end of therapy. Conclusions: It anticipates that Korean primary care doctors familiar with dementia can use the offered therapies for the first time by creating the dementia Korean medicine primary care model in this study. This is expected to maximize the range of medical services provided by Korean medicine and improve the standard of medical treatment.

• Journal of Preventive Medicine and Public Health
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• v.26 no.4 s.44
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• pp.661-671
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• 1993

In order to compare the geographical distribution of physician by level of medical care and specialty, a log linear model was applied to the annual registration data of the Korean Medical Association as of the end of December, 1991 which was supplemented from related institutions and adjusted with relevant sources. Those physicians in primary and secondary care institutions were not statistically significantly unevenly distributed by province-level catchment area. There were some differences in physician distribution among big cities, medium and small-sized cities, and counties; however, those physicians for primary care level were equitably distributed between cities and counties. Specialties for secondary care physicians were less evenly distributed in county areas than in city areas, and generalists are distributed more evenly in cities and counties than in big cities. There is a certain limitation due to underregistration in the annual physician registration to the Korean Medical Association; however, the geographical distribution of physicians has been improved quantitatively. It is strongly suggested that specialties and the level of medical care should be considered for further physician manpower studies.

• Journal of Society of Preventive Korean Medicine
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• v.16 no.1
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• pp.1-13
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• 2012

The objective of this study is to discuss the role of integrative medicine (IM) in contemporary health care settings, and how and which factors affect and facilitate the success of IM in terms of the integration of complementary and alternative medicine (CAM) and conventional medicine in primary health care (PHC). IM is meant to provide the best possible health care, for both patient and physician. The way of IM use in the developed countries presents various ways that IM can be provided, and it appears that strategies have been successfully developed to facilitate integration. Although few of the barriers to the integration of CAM and conventional medicine have been resolved, concerns over the legitimacy of CAM in health care (e.g., safety, biomedical evidence, and efficacy) are being overcome by the use of evidence-based practice in IM delivery. There are dominant models of IM that have been developed. The model types signify different levels of equity between CAM and conventional medicine in regard to the power, autonomy, and control held by each. However, the factors common to all IM models, whether describing CAM as supplementary or complementary to conventional medicine, is the concept of a health care model that aspires to be client-centred and holistic, with focus on health rather than disease as well as mutual respect among peer practitioners. Finally, this study concluded that the growth and viability of traditional Korean medicine(TKM) depend on evidence-based practices and identifying the successful influences on the integration of TKM and conventional medicine for recognition of its inherent value in PHC. Some recommendations for the integration of TKM and conventional medicine were suggested.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2901-2904
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• 2014

The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.190-195
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• 2023

Objectives: Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology. Methods: We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate. Results: In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively). Conclusions: Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions.

• Journal of Preventive Medicine and Public Health
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• v.48 no.4
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• pp.188-194
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• 2015

Objectives: The goal of this study was to identify association between the continuity of ambulatory care of diabetes patients in South Korea (hereafter Korea) and the incidence of macrovascular complications of diabetes, using claims data compiled by the National Health Insurance Services of Korea. Methods: This study was conducted retrospectively. The subjects of the study were 43 002 patients diagnosed with diabetes in 2007, who were over 30 years of age, and had insurance claim data from 2008. The macrovascular complications of diabetes mellitus were limited to ischemic heart disease and ischemic stroke. We compared the characteristics of the patients in whom macrovascular complications occurred from 2009 to 2012 to the characteristics of the patients who had no such complications. Multiple logistic regression was used to assess the effects of continuity of ambulatory care on diabetic macrovascular complications. The continuity of ambulatory diabetes care was estimated by metrics such as the medication possession ratio, the quarterly continuity of care and the number of clinics that were visited. Results: Patients with macrovascular complications showed statistically significant differences regarding sex, age, comorbidities, hypertension, dyslipidemia and continuity of ambulatory diabetes care. Visiting a lower number of clinics reduced the odds ratio for macrovascular complications of diabetes. A medication possession ratio below 80% was associated with an increased odds ratio for macrovascular complications, but this result was of borderline statistical significance. Conclusions: Diabetes care by regular health care providers was found to be associated with a lower occurrence of diabetic macrovascular complications. This result has policy implications for the Korean health care system, in which the delivery system does not work properly.

• Journal of Preventive Medicine and Public Health
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• v.52 no.5
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• pp.323-332
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• 2019

Objectives: The aim of this study was to describe general practitioners (GPs)' opinions and practices of preventive care and patients' opinions, attitudes, and behaviors towards prevention. Methods: The data stemmed from a cross-sectional national survey on prevention conducted in Switzerland from 2015 to 2016. In total, 170 randomly drawn GPs and 1154 of their patients participated. The GPs answered an online questionnaire and the patients answered a questionnaire administrated by fieldworkers present at their practices. Results: Both patients and GPs agreed that delivering preventive care is the dedicated role of a GP. It appeared that beyond classical topics of prevention such as cardiovascular risk factors, other prevention areas (e.g., cannabis consumption, immunization, occupational risks) were scarcely covered by GPs and reported as little-known by patients. In addition, GPs seemed to use a selective approach to prevention, responding to the clinical context, rather than a systematic approach to health promotion. The results also highlight possibilities to improve prevention in family medicine through options such as more supportive tools and public advertising, more time and more delegated tasks and, finally, a more recognized role. Conclusions: Despite an unfavorable context of prevention within the healthcare system, preventive care in family medicine is reasonably good in Switzerland. However, some limitations appear regarding the topics and the circumstances of preventive care delivery. A global effort is needed to implement necessary changes, and the responsibility should be broadened to other stakeholders.

• 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.

• 대한예방의학회:학술대회논문집
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• 2001.10a
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• pp.151-152
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• 2001

• Journal of the Korean Society of School Health
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• v.6 no.1
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• pp.58-68
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• 1993

This study was designed to grasp the knowledge and practice the level about visual impairment protective care of the primary school students and also analyse the state of visual impairment. The subjects of this study ware 347 students composed of 456 boys and 391 girls in primary school students. The data were collected by questionaire developed for the purpose of this study which has been made through studying references. These were carried out from the 10th to 30th of June 1992. Analysis of the data was done utilizing SPSS for percentage, mean, S.D., T-test., ANOVA and Pearson's Correlation Coefficient. The major results obtained from this study were as follows: 1. The level of the knowledge about visual impairment protective care was in intermediate range (mean on 20 point scale of 12.34, with O=definitely no), but low in aspects of preventive care for overwork of eye (mean on 5 point scale of 2.67). 2. The level of the practice about visual impairment protective care was intermediate range (mean on 20 point scale of 12.34, with O=definitely no), but low in aspects of preventive care for overwork of eye (mean on 5 point scale of 2.58). 3. Significant variables influencing knowledge of visual impairment protective care were sex (p<0.01) and grade (p<0.001). 4. Significant variables influencing practice of visual impairment protective care was living area (p<0.01). 5. Correlation between knowledge and practice: Those who have more knowledge score have more practice score (p<0.001). 6. vision impairment state 1) Student with subnormal in 0.9 or less were 26.3% in left eye and 28.4% in right eye. 2) Student with subnormal in 0.6 or less were 11.9% in left eye and 10.9% in right eye. 7. Vision impairment programs 1) Males are slightly higher in the degree of visual impairment than females. 2) Visual impairment were increased in accordance with the increase of grade. 3) Urban students are higher in the degree of visual impairment than rural students, but these seem to have no statistical meaning.