• Journal of muscle and joint health
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• v.21 no.1
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• pp.36-45
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• 2014

Purpose: The purpose of this study was to investigate the factors increasing fall risk in the residential environment risk and the perceived fall risk among the older adults who received home care services to provide information for developing a comprehensive falls intervention program. Methods: The subjects were 227 community-dwelling elderly aged 65 years and over who were taken care of by home-visiting nurses of the national health centers. The data were collected from July to August in 2012 using the Choi's residential environmental risk scale (2010) and the Hong's fall risk scale (2011). Results: Requires an assistive devices to walk, modified residential environment, health security, approval certificate of LTC, residential safety perception, residential environment risk, and perception of fall risk were statistically significant risk factors. A multiple logistic regression analysis showed that room & kitchen, physical perception, medication & ADL perception, floor-related environmental perception, and daily living tool-related perception were statistically significant predictors of fall. Conclusion: The results showed that the residential environment and the perceived fall risk were associated with fall experiences among the elderly. It is necessary to develope multifactorial intervention programs considering both environmental and perceived risk factors as well as physical risk factors to reduce and prevent falls among the elderly.

• Research in Community and Public Health Nursing
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• v.26 no.1
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• pp.11-17
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• 2015

Purpose: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. Methods: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. Results: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). Conclusion: Copayment does not seem to be a great influencing factor on beneficiaries' accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.

• Research in Community and Public Health Nursing
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• v.13 no.4
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• pp.795-807
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• 2002

Objectives: The purpose of this study was to develop a community-based nursing center model that can provide health promotion for infants and toddlers as well as a research and practice site for nursing faculty and students. Methods: Review of current health care system and health promotion programs, and workshops with brain-storming were carried out to identify needy areas of services to be provided by the nursing center. Finally, the community nursing center model was developed through expert consultation and filed visits. Results: The services and programs were developed for infants and toddlers residing in Seoul area. These services and programs include growth and developmental screening, environment and health problem assessment, infant stimulation and parent education, and self-help group. Full-time and part-time staff nurses and nurse practitioners will provide those services and offer home visiting if needed. Database system, health information system, and trainers' training programs were developed as well. Conclusion: The nursing center model developed in this study will ensure clients direct access to nursing care and increase of autonomy and accountability of nursing practices. The nursing center model focused on disease prevention and health promotion will enhance the quality of life of the infants, toddlers and their families as well as to decrease national health care expenditure.

• Korean Journal of Social Welfare
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• v.46
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• pp.319-348
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• 2001

The primary purpose of this study is to examine the buffering effect of social welfare services on the relationship between the level of older persons' impairment and burden experienced by the family caregivers. It also assessed the level of caregiving burden as well as the effect of both older person's impairment and the characteristics of the caregivers on burden. The survey data collected from 150 community residing family caregivers was used for analyses. Findings are as follows. First, the caregivers are more burdened in the deterioration of mental health, scarce time for oneself, and the suffering of social life than in other areas of burden. Second, the more severe the physical and the mental impairment of the elder, the more burden the caregivers experience. The caregivers' characteristics such as the worse mental health, the lower level of attachment to the elder, the longer caregiving hours are also related to the higher level of caregiving burden. Third, the caregivers' use of adult day care and respite care services buffer the relationship between the level of impairment of older persons and the caregiving burden. However, social work counselling, visiting nurse, homemaker services do not have such buffering effects. Among informal support, instrumental support buffers the relationship between the elder's physical impairment and burden, while emotional support buffers the relationship between the elder's mental impairment and burden. According to the results, implication for social welfare services and practice methods for the family caregivers was discussed.

• Journal of Home Health Care Nursing
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• v.26 no.3
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• pp.253-264
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• 2019

The aim of this review is to present a German system of an outpatient care center under the German Health Insurance Act and home care (integration of medical care, basic care, bathing) under the Long-Term Care Insurance Act. This idea of a German integrated home care system should contribute to the development of a Korean home care model. Prior the introduction of long-term care insurance (1995), and with the of the health insurance law (1989), German outpatient care centers already provided medical and basic care services for patients with acute and chronic symptoms. Since 1995, patients with acute symptoms and rehabilitation periods under the Health Insurance Act have been eligible for home care. The Long-Term Care Insurance Act is intended for all citizens who are unable to carry out their daily activities for more than six months. In 2017, 13,657 (97%) of 14,050 outpatient care centers provided home care services after long-term care and health insurance. In other words, patients in Germany can use home care in both the acute and chronic phase at the same home care center, or 'integrated home-care center'.

• Korean Journal of Health Education and Promotion
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• v.33 no.4
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• pp.67-77
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• 2016

Objectives: The study was to propose strategies and directions how to manage the hypertension and diabetes in communities. Methods: The survey data from 606 patients with hypertension or diabetes based on Community Health Survey, 2013 were analyzed and the hypertension and diabetes projects in communities for last 10 years were reviewed. Results: The patients visiting the primary clinics had statistically significant lower rates than those of teaching hospitals in physician's recommendation experience, perception level of attention from doctors, self-efficacy and health habit practice level. Since the Hypertension and diabetes registration and management system in 2007, there have been several trials for management of hypertension and diabetes such as Chronic diseases management system on the primary clinics, Community based primary medical care pilot projects, Post-national health screening management, and Pilot project on reimbursement for chronic diseases care services. Conclusions: The upmost urgent task might be to have a support system for patients' self care affiliated with primary clinics. To achieve it, it is necessary to expand the current Hypertension and diabetes registration and management system into nation and to find a way to attract the active participation from primary clinics.

• Journal of Preventive Medicine and Public Health
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• v.54 no.2
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• pp.129-136
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• 2021

Objectives: This study examined demographic factors hampering access to healthcare at hospitals and suggests policy approaches to improve healthcare management in Thailand. Methods: The data for the study were drawn from a health and welfare survey conducted by the National Statistical Office of Thailand in 2017. The population-based health and welfare survey was systematically carried out by skilled interviewers, who polled 21 519 384 individuals. The independent variables related to demographic data (age, sex, religion, marital status, education, occupation, and area of residence), chronic diseases, and health insurance coverage. The dependent variable was the degree of access to healthcare. Multiple logistic regression analysis was subsequently performed on the variables found to be significant in the univariate analysis. Results: Only 2.5% of the population did not visit a hospital when necessary for outpatient-department treatment, hospitalization, or the provision of oral care. The primary reasons people gave for not availing themselves of the services offered by government hospitals when they were ill were-in descending order of frequency-insufficient time to seek care, long hospital queues, travel inconvenience, a lack of hospital beds, unavailability of a dentist, not having someone to accompany them, and being unable to pay for the transportation costs. Multiple logistic regression analysis showed that failure to access the health services provided at hospitals was associated with demographic, educational, occupational, health welfare, and geographic factors. Conclusions: Accessibility depends not only on health and welfare benefit coverage, but also on socioeconomic factors and the degree of convenience associated with visiting a hospital.

• Journal of the Korea Convergence Society
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• v.9 no.1
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• pp.325-330
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• 2018

The study examined the impact of medical servicescape, human services, and effects on perceived value and customer satisfaction. From July 1, 2016 to August 31, 2016, a total of 300 outpatients visiting the university hospital and general hospital in Ulsan area participated the study. As a result, the general features of the Servicescape were more important to the aged and the higher the academic background, the higher the scores of Human Service and perceived value were revealed. There was a positive correlation between the service schedule of the medical institution, human service, perceived value, and customer satisfaction. And the factors affecting customer satisfaction were in order of human service (${\beta}=0.382$), perceived value (${\beta}=0.376$). The service scapegoats and personal services offered by customers visiting healthcare providers play an important role in understanding the internal health and needs of customers, and this research results will serve as a basic material for strengthening the competitiveness of medical institutions.

• The Korean Journal of Emergency Medical Services
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• v.11 no.1
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• pp.53-64
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• 2007

Purpose: Ths study aims to examine characteristics of patients using emergency room after execution of five-day workweek system by government and provide basic materials for operation of efficient emergency room. Methods: Data were collected tbrough medical records of patients visiting emergency room from July of 2004 to October of 2006 and they were analyzed with SPSSlPC 10.0. Conclusion : 1. The number of patients visiting emergency room was average 16.7 persons a day in 2004, 17.5 in 2005 and 18.6 in 2006 and it was found that it was increasing every year since the execution of five-day workweek system 2. Gender distribution of subjects using emergency room was higher in male than in female every year. 3. Means of transport to emergency room were mostly private car and others(public transport or on foot), but use of ambulance was increasing. 4. Residential areas of subjects were mostly 'Myeon area' in 2004~2005, but it was changed to residents at 'Eup area' in 2006. 5. Distribution of patients by medical departments was highest in internal medicine and surgery in 2004~2006 and rate of visiting pediatrics was increasing every year. 6. Time to stay at emergency room was most at 'below 30 min'. in 2004~2006, but cases of stay for 'more than 2 hours' were increasing every year. 7. On presence or absence of trauma in patients visiting emergency room, rate of visit to emergency room with 'no trauma' was higher and this result was increasing every year. 8. As a result of classifying severity of patients visiting emergency room, use rate of emergency room by 'non-emergency' patients was over 90% in 2004~2006 and such a phenomenon was deepened in 2006 compared to that in 2004. 9. Measures after emergency care of patients were most in case of 'discharge' in 2004~2006, but cases of admission to hospital after emergency care were increased every year. 10. According to use of emergency room by a day of the week, use on Sunday was most frequent in 2004~2006, but use on Friday the day before holiday was increasing. 11. According to distribution by age, use by those between '40~49' was most in 2004~2005, but use by those 'below 10' was most in 2006. 12. According to time to visit emergency room, using emergency room at "15:31~23:30 was most in 2004~2006, cases of visiting emergency room at day working hour were decreased every year and those at evening and night working hours were increased. Conclusion: In sum, it was found that characteristics of patients visiting emergency room and their actual status were changed after the execution of five-day workweek system and efforts to rearrange emergency medical system are required.

• Journal of Korean society of Dental Hygiene
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• v.23 no.5
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• pp.351-360
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• 2023

Objectives: This study is based on a visiting oral health care intervention program in the community care. This qualitative study was conducted through in-depth interviews to identify awareness and attitudes regarding intervention program among older adults. Methods: The research team visited the homes of the target older adults and conducted in-depth interviews for approximately an hour using a semi-structured questionnaire. The collected voice recordings were transcribed using Clova Note, and AI program by Naver. Using the 'Word Cloud Generator 3.7' program, words of high importance and interest from interview answers were extracted, visualized, and analyzed. Results: Participating older adults acknowledged that their quality of life related to oral health could be improved by increasing the level of oral health awareness and oral health knowledge through the intervention program. In addition, the older adults indicated that their oral hygiene management ability improved compared to before the intervention through expert oral hygiene management and oral health education. Further, as the level of oral health knowledge increased, so too did satisfaction with the intervention program increase. Conclusions: The intervention program for visiting oral health care showed a positive effect on the awareness and attitude of older adults. Thus, it is suggested that education for continuous competency enhancement of dental hygienists and multidisciplinary education for the improvement of general health and quality of life of older adults should be promoted.