• Journal of Korean Biological Nursing Science
• /
• 제18권3호
• /
• pp.144-152
• /
• 2016

Purpose: This study compares beneficiaries of Korean Medicaid with those under the National Health Insurance program, seeking to understand how each group utilizes their healthcare. Methods: Data were obtained from a Health Promotion Survey in 2005. Health status was measured by the respondents' perception of health. Health service utilization included the availability of healthcare services, the type of healthcare institution, and intent to revisit. Predisposing and enabling factors, as well as health care needs were used for this study. Results: Compared to National Health Insurance beneficiaries, Medicaid beneficiaries reported lower levels of health status and fewer enabling factors. They had more chronic diseases and disabilities. Education level, existence of chronic diseases, exercise patterns, and disabilities were associated with health status. Conclusion: We found that Medicaid beneficiaries had fewer resources and higher levels of health needs. As Medicaid is reformed, policy makers and administrators should understand healthcare utilization behaviors of Medicaid beneficiaries and the factors hindering access to care.

• 보건행정학회지
• /
• 제34권2호
• /
• pp.185-195
• /
• 2024

연구배경: 장애인의 일상적 건강관리 미흡과 낮은 의료접근성으로 인해 다양한 건강문제 발생 및 과다한 의료비 지출 부담이 발생하고 있다. 이에 "장애인건강권법"에 근거하여 2018년 장애인 건강주치의제도 시범사업을 시행하였으나 2021년 기준 전체 중증장애인 중 시범사업 참여자는 0.2%에 불과하다. 이에 본 연구는 수요자의 장애인 건강주치의 참여 활성화를 위한 시사점을 얻고자, 시범사업 등록 여부와 시범사업 이용수준의 영향요인을 규명하고자 하였다. 방법: 2018년 5월 30일부터 2021년 12월 31일까지 시범사업 정보와 국민건강보험 데이터를 연계하여 이분형 로지스틱 회귀분석과 위계적 다중회귀분석을 통해, 장애인건강주치의 참여 장애인의 시범사업 등록 및 서비스 이용횟수에 영향을 미치는 요인을 분석하였다. 독립변수는 장애유형, 인구사회경제학적 특성과 건강상태(만성질환의 개수, 찰슨동반상병지수(Charlson comorbidity index [CCI]), 외래민감질환 및 복약불순응과 다제약제관리 필요의 해당 여부), 시범사업 서비스 이용 관련 변수를 포함하였다. 결과: 시범사업의 등록 여부에 영향을 주는 요인 분석결과, 주장애관리 가입 대상에 해당하는 장애유형(지체, 뇌병변, 시각, 지적, 정신, 자폐성 장애인)이 그 외 장애유형(odds ratio [OR], 4.157)보다, 군 지역 거주자보다 특별광역시 거주자(OR, 4.330)와 시 지역 거주자(OR, 3.332)가 시범사업에 등록할 확률이 높았으며, CCI와 만성질환 개수와 같은 건강수준의 영향도 있었다. 그러나 주치의 서비스 이용수준의 결정요인으로 참여자의 인구사회학적 특성(장애유형, 연령, 의료보장 형태, 거주지역)과 건강수준(만성질환 개수, CCI) 등 개인적 요인보다 시범사업 서비스 가입 형태에 해당하는 변수군(수요자가 등록한 주치의의 소속 및 서비스 유형)이 더 높은 설명력(20.4%)을 보였다. 결론: 수요자의 장애유형과 지역과 건강수준에 따른 시범사업의 참여 편차를 고려하여 향후 서비스 개발이 필요하며, 수요자의 서비스 이용수준에 공급자의 요양기관 형태나 서비스 유형의 영향력이 큰 바 향후 공급자의 참여 양상과 수요자의 참여수준과의 관계를 분석하는 연구가 필요할 것이다.

• 한국농촌간호학회지
• /
• 제4권1호
• /
• pp.51-57
• /
• 2009

Purpose: This study was done to learn from the development of rural health nursing in developed countries. Method: A literature search was done using keywords such as "rural and nursing" or "rural and health" from the database CHINAL and website of institutions related to rural health and nursing. Results: In Australia, the type of rural health institution was categorized according to the population size and nursing service was done differently according to area. It is unique to Canada to have the Canadian Association of Rural and Remote Nursing, which published the survey report "the Nature of Nursing Practice in Rural and Remote Canada". In the U.S., the role of nurse practitioners in rural communities was relatively well developed and a diverse nursing care model was demonstrated. To improve health care access in rural communities, financial and political support by the governments has been part of long-term plans in the three countries. Conclusion: It is very informative to identity the difference and similarity in rural health nursing in three developed countries. For the future development of Korean rural nursing, suggestion can be made in terms of research, education and policy development.

• 보건행정학회지
• /
• 제27권1호
• /
• pp.56-62
• /
• 2017

Background: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. Methods: The panel data of the year 2010-2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. Results: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. Conclusion: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents' health, etc.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권23호
• /
• pp.10071-10077
• /
• 2015

Background: Cervical cancer has become a major public health problem worldwide. Iran, like other developing countries, is facing a number of challenges in managing the disease. This qualitative study documents challenges encountered in cervical cancer preventing programs in Iran. Materials and Methods: In-depth interviews were conducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, five specialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist in Mashhad Iran, between May and December of 2012. The sample was selected purposively until data saturation was achieved. Data credibility verified via allocated sufficient time for data collection, using member checking and peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. ti software. Results: Findings from data analysis demonstrated 2 major themes and 6 categories about challenges of providing cervical cancer prevention programs including: individual and social challenges (cognitive/behavioral challenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency of health care providers and access to services). Each category included some subcategories. Conclusions: Managing the cervical cancer prevention programs need to include the consideration of individuals, health care providers and health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges, Poor intersectional collaboration and coordination and intra-sectional management, financing and competency of health care providers are essential steps toward significantly reducing the burdens of cervical cancer.

• 한국정보관리학회:학술대회논문집
• /
• 한국정보관리학회 2006년도 제13회 학술대회 논문집
• /
• pp.191-196
• /
• 2006

Traditionally, nurses keep the written patient records, which are referred as nursing care plan. Nursing care plan reports are one of the most important documents in the application of nursing processes. Typically, nurses prepare the plans by including general patient information as well as the patient's medical history information. In addition, the patient's developmental history and other specific health related information are part of the plans. The plans are usually concluded with the goals of the nursing care plan, nursing diagnoses, expected outcomes of the care, and possible nursing interventions. The nursing diagnoses, outcomes, and interventions are defined by North American Nursing Diagnosis Association (NANDA). This means that the nurses will select the appropriate diagnoses, outcomes, and interventions from an approved set. We developed a web-based nursing care plan generation system. In this paper, we report our work on developing a visual interface to the NANDA nursing diagnoses, outcomes, and interventions database as a part of the web-based nursing care plan generation system.

• 보건행정학회지
• /
• 제4권1호
• /
• pp.138-175
• /
• 1994

The objectives of this study are (i) to review current situations and problems of the occupational health care system with emphasis on reforming the organizations and services, (ii) to find out a disirable occupational health system model based on integration of the occupational health system and the general health system, and finally, (iii) to suggest policy implications in occupational health services in the light of objectives of the newly emerging national health insurance reform in Korea. The major policy implications of this study are as follows: 1. In the long-run, within the occupational health system, preventive occupational health services such as employees' physical check-up, working environment examination, etc should financially be integrated with industrial accident compensation insurance. Currently separately paying expenses for each different category of services by the owner of an enterprise should be disbursed once through the payment of contributions of industrial accident compensation insurance. And then, it is necessary to strengthen and expand the role and function of industrial accident compensation insurance to cover preventive occupational health services. 2. The occupational health system should be integrated with general health system for its effective management. For the short-term policy, it is necessary to eliminate fiscal and access barrier between industrial accident compensation insurance and national health insurance by means of ex post facto settlement of accounts. The duplication of employees' physical check- ups between under the health insurance program and under the industrial health services must be coordinated in a manner either through mutual authorization by the two parties concerned or through merge into the health insurance. 3. The intent of current employees' physical check-up system focused on detection of occupational diseases, should be converted to an idea of medical surveillance system or biological moritoring system. The introduction of medical surveillance or biological monitoring system is a necessary condition to build a positive, effective and inexpensive occupational health care system.

• 가정∙방문간호학회지
• /
• 제14권1호
• /
• pp.18-22
• /
• 2007

Purpose: The rapid change to an aging society generates an increase in the incidence of chronic diseases. Many chronic patients have been facing their illnesses without enough preparation. In order to solve these problems, we designed and tested a public healthcare service based on ubiquitous technology. Method: Telemedicine has emerged as new medical care system of chronic disease. However, public potential of its technology is difficult to know under current traditional health care system. In this work, we developed a Personal Digital Access (PDA) phone based healthcare system by trained visiting nurses for elderly patients. A field test was performed by SeongBuk Public Health Center in Seoul, Republic of Korea (ROK). Result: Surveys were generated to assess the effects of this system compared to conventional public health system. Findings of trials demonstrate that healthcare coordination enhanced by PDA phone technology is satisfactory to the patients and nurses compared to previous one because prompt responses arouse their recognition of health. Conclusion: Ubiquitous healthcare system applied to public health service proved to be efficient and time-saving to monitor and control the chronic illnesses of large population.

• Clinical and Experimental Reproductive Medicine
• /
• 제44권4호
• /
• pp.171-174
• /
• 2017

While many fertility preservation (FP) options now exist for reproductive-aged cancer patients, access to these services continues to be limited. A comprehensive FP program should be organized to serve oncofertility patients effectively. Also, much effort is needed from various individuals-patients, specialists from various fields, and consultants-to facilitate FP in a timely manner. Various challenges still exist in improving access to FP programs. To improve access to FP treatment, it is important to educate oncologists and patients via electronic tools and to actively navigate patients through the system. Reproductive endocrinology practices that receive oncofertility referrals must be equipped to provide a full range of options on short notice. A multidisciplinary team approach is required, involving physicians, nurses, mental health professionals, office staff, and laboratory personnel. The bottom line of FP patient care is to understand the true nature of each patient's specific situation and to develop a patient flow system that will help build a successful FP program. Expanding the patient flow system to all comprehensive cancer centers will ensure that all patients are provided with adequate information regarding their fertility, regardless of geography.

• 농촌의학ㆍ지역보건
• /
• 제17권2호
• /
• pp.113-121
• /
• 1992

In order to estimate the pattern of medical care utilization and recognition for health factor among the inhabitants in Wan-do district which is located off the southern seashore from mainland Korea, household interview survey was performed from January 15 to 30, 1990 in Wan-do Gun area. The results observed were following: 1. Among the users of medical facilities 40.8% used public health facility as first contact facility. Lower the income level was and longer the residency duration was, the utilization rate of public health facilities was higher. By age groups and medical security status the utilization pattern was likely to disperse to local clinic and secondary contact medical resources. 2. Medical expense and access time were significantly different between primary contact and secondary contact medical resources. 3. Public health facility was recognized as the favoured institute having advantage of geographic and economic accessibility. 4. Statistically significant determinants in public health facility utilization among total medical service were the region, the medical expense, and the access time.