• 제목/요약/키워드: Access to Health Care

검색결과 333건 처리시간 0.026초

미국 조기헤드스타트의 문헌고찰을 통한 한국의 영아보육에 관한 연구 (Implications of American Early Head Start for the Korean Infant/toddler Care System)

  • 김지은
    • 대한가정학회지
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    • 제43권12호
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    • pp.97-111
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    • 2005
  • Early Head Start (EHS) can provide services to a child and family from pre-birth until the child is three years old. Services are comprehensive, intensive, individualized and flexible according to child and family needs, and integrated with community service delivery systems. The local program designs and operations were developed and carried out within the framework of the Head Start Revised Performance Standards, which included specific provisions for services to pregnant women, infants and toddlers and emphasized prevention, early intervention, safety, and health education. As with preschool Head Start, EHS programs are required to make available 10 percent of their enrollment for infants and toddlers with disabilities as defined by Part C regulations of the state in which the program operated. Quality child care has become a priority for EHS. A majority of EHS children need child care, and the quality is important to their development. An evaluation of EHS in 17 programs selected from the first program cohorts showed that the program had significant and positive impacts on a wide range of parent and child dimensions, some with implications for children's later school success. Among the issues for policy attention identified by American EHS for the Korean system are: - The need to create a comprehensive infant/toddler care system - The need to address access of teachers for young children - The need to improve quality.

Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest-Posttest Study

  • Ketelaar, Sarah M.;Nieuwenhuijsen, Karen;Bolier, Linda;Smeets, Odile;Sluiter, Judith K.
    • Safety and Health at Work
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    • 제5권4호
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    • pp.216-221
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    • 2014
  • Background: Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants. Methods: We applied a pretest-posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes. Results: One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p = 0.01) and work-related fatigue (p < 0.01). Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d = .23) in the participants who had logged onto an EMH intervention (20%, n = 26). Conclusion: The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

A Peer-support Mini-counseling Model to Improve Treatment in HIV-positive Pregnant Women in Kupang City, East Nusa Tenggara, Indonesia

  • Artha Camellia;Plamularsih Swandari;Gusni Rahma;Tuti Parwati Merati;I Made Bakta;Dyah Pradnyaparamita Duarsa
    • Journal of Preventive Medicine and Public Health
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    • 제56권3호
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    • pp.238-247
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    • 2023
  • Objectives: Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers' knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services. Methods: This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants. Results: Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs' side effects; and the quality of health workers and HIV services. Conclusions: There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.

파라과이 농촌지역의 보건소 건립 후 접근성과 이용만족도에 관한 연구 (A study on the accessibility and utilization satisfaction of health centers in rural area, Paraguay)

  • 김지언;정민아;남은우
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제29권2호
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    • pp.17-26
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    • 2023
  • Purpose: The purpose of this study is to identify policy implications for the construction of public health facilities in the field of international cooperation, by examining the case of establishing a health care delivery system using a public health center in a rural area of Paraguay. Methods: Firstly, to map the capacity of the 20 public health centers that were studied, we used the WHO Capacity Mapping tool to select and analyze relevant items. Secondly, to assess the utilization of public health centers, we conducted a direct visit survey and analyzed the results using the M-survey tool. Results: The floor plan of each public health center, the structure of the health center, the size of the population served by each health center, the number of monthly visitors, medical human resources, and the budget were classified by health center for comparative analysis. In addition, by utilizing the M-survey tool, we analyzed the general characteristics of the respondents, their perceptions of the purpose and accessibility of public health centers, their satisfaction with using public health centers, and the level of demand for public health centers to play a role in promoting community health. Implications: The results of this study suggest that access to public health facilities for residents in the research area was improved. By classifying public health centers into two types, these centers can perform the functions and roles of primary health facilities. A patient request and evacuation system was established in the research area. Finally, a network, such as a social prescribing program, is needed so that public health centers can function as a "setting" for community members to live together.

사업장 건강증진사업의 실태 및 건강증진 프로그램 요구도 (A Survey of Workplace Health Promotion Activities and their Health Promotion Program Need)

  • 김영임;정혜선;이소영;김숙영;이강재;김순례
    • 지역사회간호학회지
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    • 제17권2호
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    • pp.195-209
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    • 2006
  • Purpose: This study attempted to access the health promotion activities and employee's health promotion needs in workplaces. Methods: Subjects were 280 health care managers employed at small to large scale enterprises in national-wide areas of Korea. The instrument was a structured questionnaire included characteristics of workplace and respondents, health promotion activities, health promotion needs, and bottlenecks to operate programs. Data was analyzed using SAS 8.1 by applying $x^2-test$, t-test and ANOVA. Results: 1, 25.4% of the total workplaces employed health care managers. 2. Musculoskeletal management programs(49.6%) were the highest operating program. 3. The highest needs of health promotion programs were lifestyle management and disease prevention. 4. Health promotion activities were significantly different according to the type and size of workplaces. The programs were more frequently applied in manufacturing industries than non-manufacturing and in large-scale enterprises than small and middle-scale enterprises. 5. The needs of health promotion programs were high in non-manufacturing industries than manufacturing industries in all programs. 6. The major bottlenecks to operate programs were the difficulty in securing time, lack of budgets and lack of legal regulations. Conclusions: Health promotion activities were linked to their work environments including budgets, time, and law. Therefore, to operate effective health promotion programs in workplaces, various health promotion programs are required to be developed and systems for governmental support and management should be established.

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Performance Analysis of Multiple-Hop Wireless Body Area Network

  • Hiep, Pham Thanh;Hoang, Nguyen Huy;Kohno, Ryuji
    • Journal of Communications and Networks
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    • 제17권4호
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    • pp.419-427
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    • 2015
  • There have been increases in the elderly population worldwide, and this has been accompanied by rapid growth in the health-care market, as there is an ongoing need to monitor the health of individuals. Wireless body area networks (WBANs) consist of wireless sensors attached on or inside the human body to monitor vital health-related problems, e.g., electrocardiograms (ECGs), electroencephalograms (EEGs), and electronystagmograms (ENGs). With WBANs, patients' vital signs are recorded by each sensor and sent to a coordinator. However, because of obstructions by the human body, sensors cannot always send the data to the coordinator, requiring them to transmit at higher power. Therefore, we need to consider the lifetime of the sensors given their required transmit power. In the IEEE 802.15.6 standard, the transmission topology functions as a one-hop star plus one topology. In order to obtain a high throughput, we reduce the transmit power of the sensors and maintain equity for all sensors. We propose the multiple-hop transmission for WBANs based on the IEEE 802.15.6 carrier-sense multiple-access with collision avoidance (CSMA/CA) protocol. We calculate the throughput and variance of the transmit power by performing simulations, and we discuss the results obtained using the proposed theorems.

Current treatment status and medical costs for hemodialysis vascular access based on analysis of the Korean Health Insurance Database

  • Lee, Hyung Seok;Ju, Young-Su;Song, Young Rim;Kim, Jwa Kyung;Choi, Sun Ryoung;Joo, Narae;Kim, Hyung Jik;Park, Pyoungju;Kim, Sung Gyun
    • The Korean journal of internal medicine
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    • 제33권6호
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    • pp.1160-1168
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    • 2018
  • Background/Aims: The Republic of Korea is a country where the hemodialysis population is growing rapidly. It is believed that the numbers of treatments related to vascular access-related complications are also increasing. This study investigated the current status of treatment and medical expenses for vascular access in Korean patients on hemodialysis. Methods: This was a descriptive observational study. We inspected the insurance claims of patients with chronic kidney disease who underwent hemodialysis between January 2008 and December 2016. We calculated descriptive statistics of the frequencies and medical expenses of procedures for vascular access. Results: The national medical expenses for access-related treatment were 7.12 billion KRW (equivalent to 6.36 million USD) in 2008, and these expenses increased to 42.12 billion KRW (equivalent to 37.67 million USD) in 2016. The population of hemodialysis patients, the annual frequency of access-related procedures, and the total medical cost for access-related procedures increased by 1.6-, 2.6-, and 5.9-fold, respectively, over the past 9 years. The frequency and costs of access care increased as the number of patients on hemodialysis increased. The increase in vascular access-related costs has largely been driven by increased numbers of percutaneous angioplasty. Conclusions: The increasing proportion of medical costs for percutaneous angioplasty represents a challenge in the management of end-stage renal disease in Korea. It is essential to identify the clinical and physiological aspects as well as anatomical abnormalities before planning angioplasty. A timely surgical correction could be a viable option to control the rapid growth of access-related medical expenses.

키르키즈스탄 이주민 마을 지역사회기반 영유아 건강증진 예비사업 평가 (Evaluation of a Community-based Child (Infants and Toddlers) Health Promotion Pilot Project in a Migrant Village in Kyrgyzstan)

  • 신현숙;이유나;이숙정;장윤경
    • Child Health Nursing Research
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    • 제25권4호
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    • pp.406-416
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    • 2019
  • Purpose: Children in migrant villages in Kyrgyzstan have a high incidence of anemia and need effective health promotion programs. The purpose of this study was to evaluate a pilot study of a health promotion project for infants and toddlers based on community participation. Methods: This was a retrospective study conducted to evaluate the effectiveness of the project. The project was carried out by nurses at a public health center, community health workers, and local residents in a migrant village. After the operational system of the project was established, health assessments, child-care education, provision of vouchers for iron supplements, and activities to improve residents' awareness were conducted during 6 months among 100 children, of whom 85 were finally analyzed. Results: In international health projects, close cooperation of the project team with community residents and health workers is important. Access to the community-based program was feasible in the socially and economically poor migrant village, and improvements were shown in children's anemia and awareness of health care. Conclusion: By focusing on the effective aspects of this preliminary project, plans to utilize community health workers and promotion strategies can be added to the main project to improve health promotion among children in this area.

일부 농촌지역 주민의 보건지소 이용 양상과 관련요인 (Rural Health subcenter Utilization Pattern and Its Related Factors)

  • 손석준
    • 농촌의학ㆍ지역보건
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    • 제19권2호
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    • pp.97-106
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    • 1994
  • In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the inhabitants in Kogsung district, a questionnaire survey was carried out for objects of 708 population. The results observed were as follows; 1. The annual utilization rate of a rural health subcenter for a basic health service unit was 27.5 per 100 persons, and annual mean visiting times was 1.43 times. 2. The most frequent disease by, annual health subcenter utilization illness was respiratory disease(26.5%), and the next was musculoskeletal disease(23.9%), gastrointestinal disease(15.9%) by order. 3. Favorite reasons for community health subcenter utilization were lower medical cost(23.4%), near distance from living place(20.7%) and lower disease severity(19.5%) by order. But disfavorite reasons for it were non effective treatment(26.2%), insufficient equipment(25.4%) and absence of specialist(17.4%) by order. 4. Insufficient items about community health subcenter utilization were restriction of treatment limit(47.1%), lower reliance(22.4%) and not punctral(21.8%) by order. 5. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization were age, educational level and the nearest medical facility class. 6. There was no difference between recognition for a community health subcenter's work and actual utilizing service, and desirable works for it were disease preventing service, disease control of elderly and sanitation control by order. These results suggested that to increase the utilization of rural health subcenter and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, expansion of health equipment and recognition about access time.

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정신건강 증진과 자살예방을 위한 ICT 융합 국내외 사례 연구 (Domestic and Foreign Case Studies on ICT Convergence for Mental Heath Improvement and Suicide Prevention)

  • 김호경;신동희
    • 한국콘텐츠학회논문지
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    • 제15권5호
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    • pp.592-606
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    • 2015
  • 전 연령층에 걸친 우울증 및 정신질환과 꾸준한 자살률 증가는 정부경쟁력을 크게 떨어뜨리는 심각한 사회문제이다. 정부는 정신건강을 증진시키고 자살을 예방하기 위해 다양한 정책을 실시하고 있으나 시행과정 및 연계 관리 체계 등에서 여러 문제점들이 제기된다. 본 연구는 정신건강분야에 있어 ICT 융합방안의 실태와 방향성을 파악하기 위해 국내외 사례를 살펴보았다. 미국과 영국에서는 ICT를 융합한 원격 정신치료서비스를 지역노인, 소아청소년, 취약계층 등에 제공하고 있다. 국내는 노인자살을 방지하기 위해 독거노인을 대상으로 응급알림 장치를 설치하거나 우울증과 치매 완화를 위한 기술이 개발 중에 있다. 고령화시대에 사회경제적 비용을 줄이고 보편적 복지실현을 위해 ICT 융합 정신건강관리 서비스가 필요하다. 이에 원격정신진료와 관련하여 첨예하게 갈등을 보이는 의료법과 의료기기에 대한 사회적 합의, 생애전주기에 걸쳐 이용자의 정신적 특성을 고려한 효과성 연구, 인구 밀집도와 의료접근성이 낮은 지역 중심의 특화된 정책 등이 제고되어져야한다.