• Title/Summary/Keyword: Access to Health Care

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Preconception care knowledge and information delivery modes among adolescent girls and women: a scoping review

  • Wiwit Kurniawati;Yati Afiyanti;Lina Anisa Nasution;Dyah Juliastuti
    • Women's Health Nursing
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    • v.29 no.1
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    • pp.12-19
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    • 2023
  • Purpose: The aim of this study was to conduct a scoping review of knowledge and information delivery modes related to preconception care (PCC) among adolescent girls and women. Methods: A scoping review was performed on studies selected from five electronic databases (Cochrane Library, PubMed, Science Direct, CINAHL/EBSCO, and ProQuest), published between 2012 and 2022, with predetermined keywords and criteria. We included English-language research articles available in full text and excluded irrelevant articles. Results: This study included eight articles, comprising seven quantitative studies and one qualitative study conducted among adolescent girls and women. Five were from low- and middle-income countries and three were from high-income countries. The synthesized themes generated from the data were PCC knowledge and PCC information delivery modes and effectiveness. In general, adolescent girls and women were found to have basic PCC knowledge, including risk prevention and management and a healthy lifestyle, although more extensive knowledge was found in higher-income countries than in lower-income countries. The delivery modes of PCC information have grown from individual face-to-face conventional methods, which are used predominantly in lower-income countries, to more effective digital mass media. Conclusion: Globally, many women still have insufficient knowledge regarding PCC, as not all of them receive access to PCC information and support. PCC promotion efforts should be initiated earlier by involving a wider group of reproductive-age women and combining individual, in-group, face-to-face, and electronic delivery modes.

A Development of Healthcare Monitoring System Based on Internet of Things Effective

  • KIM, Song-Eun;MUN, Ji-Hui;KIM, Kyoung-Sook;KANG, Min-Soo
    • Korean Journal of Artificial Intelligence
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    • v.8 no.1
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    • pp.1-6
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    • 2020
  • The Recently there has been a growing interest in health care due to the COVID-19 situation. In this paper, we intend to develop a healthcare monitoring system to provide users with smart healthcare systems in line with the healthcare 3.0 era. The system consists of a wireless network between various sensors, Android smartphones, and OLEDs using Bluetooth, and through this, a health care monitoring system capable of collecting user's biometric information and managing health by receiving data values of sensors connected to Arduino. In conclusion, the user's BPM value was calculated using the heart rate sensor, and the exercise intensity can be adjusted through this. In addition, a step derivation algorithm is implemented using an acceleration sensor, and calorie consumption can be measured using the step and weight values. As such, the heart rate, step count, calorie consumption data can be transmitted to a smartphone application through a Bluetooth module and output, and can be output to an OLED for users who are not easy to access the smartphone. This healthcare monitoring system can be applied to various groups and technologies.

Assessment of Medical Service Quality Perceived by In-patients of Geriatric Hospitals -Using Revised IPA Applying the Kano's Model- (노인요양병원 입원환자가 지각하는 의료서비스품질 평가 -Kano모델에 근거한 Revised IPA를 활용-)

  • Ko, Min-Seok
    • The Korean Journal of Health Service Management
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    • v.7 no.1
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    • pp.133-144
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    • 2013
  • The present study is aimed at assessing medical service quality as perceived by in-patients of geriatric hospitals and at analyzing the excitement factors by using revised IPA Applying the Kano's model for users' satisfaction. The data was collected from Nov. 5 to Dec. 7, 2012. Among a total of 503 cases of questionaries, only 419 cases were used. To data were analyzed by PASW statistics 18.0 and revised IPA applying Kano's model. The paired t-test results reveal that satisfaction was higher than the expectation level at a statistically significant level across all the medical service quality factors. The revised IPA results categorized facility convenience, hospitalization and care, and kindness as basic factors and medical reliability and access as excitement factors. In conclusion, medical reliability and access, which were identified as excitement factors of medical service quality, are essential opportunity factors for users and should accordingly be used as strategic factors to increase satisfaction with a geriatric hospital and induce customer surprise.

Service Quality beyond Access: A Multilevel Analysis of Neonatal, Infant, and Under-Five Child Mortality Using the Indian Demographic and Health Survey 2015~2016

  • Kim, Rockli;Choi, Narshil;Subramanian, S.V.;Oh, Juhwan
    • Perspectives in Nursing Science
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    • v.15 no.2
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    • pp.49-69
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    • 2018
  • Purpose: The purpose of this study was to derive contextual indicators of medical provider quality and assess their relative importance along with the individual utilization of antenatal care (ANC) and institutional births with a skilled birth attendant (SBA) in India using a multilevel framework. Methods: The 2015~2016 Demographic and Health Survey (DHS) from India was used to assess the outcomes of neonatal, infant, and under-five child mortality. The final analytic sample included 182,980 children across 28,283 communities, 640 districts, and 36 states and union territories. The contextual indicators of medical provider quality for districts and states were derived from the individual-level number of ANC visits (<4 or ${\geq}4$) and institutional delivery with SBA. A series of random effects logistic regression models were estimated with a stepwise addition of predictor variables. Results: About half of the mothers (47.3%) had attended ${\geq}4$ ANC visits and 75.8% delivered in institutional settings with SBAs. Based on ANC visits, 276~281 districts (43.1~43.9%) and 13~16 states (36.5~44.4%) were classified as "low" quality areas, whereas 268~285 districts (41.9~44.5%) and 8~9 states (22.2~25.0%) were classified as "low" quality areas based on institutional delivery with SBAs. Conditional on a comprehensive set of covariates, the individual use of both ANC and SBA were significantly associated with all mortality outcomes (OR: 1.17, 95% CI: 1.08, 1.26, and OR: 1.10, 95% CI: 1.02, 1.19, respectively, for under-five child mortality) and remained robust even after adjusting for contextual indicators of medical provider quality. Districts and states with low quality were associated with 57~61% and 27~43% higher odds of under-five child mortality, respectively. Conclusion: When simultaneously considered, district- and state-level provider quality mattered more than individual access to care for all mortality outcomes in India. Further investigations are needed to assess the importance of improving the quality of health service delivery at higher levels to prevent unnecessary child deaths in developing countries.

Meta-synthesis Exploring Barriers to Health Seeking Behaviour among Malaysian Breast Cancer Patients

  • Yu, Foo Qing;Murugiah, Muthu Kumar;Khan, Amer Hayat;Mehmood, Tahir
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.145-152
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    • 2015
  • Barriers to health seeking constitute a challenging issue in the treatment of breast cancer. The current meta-synthesis aimed to explore common barriers to health seeking among Malaysian breast cancer patients. From the systematic search, nine studies were found meeting the inclusion criteria. Data extraction revealed that health behavior towards breast cancer among Malaysia women was influenced by knowledge, psychological, sociocultural and medical system factors. In terms of knowledge, most of the Malaysian patients were observed to have cursory information and the reliance on the information provided by media was limiting. Among psychological factors, stress and sense of denial were some of the common factors leading to delay in treatment seeking. Family member's advice, cultural beliefs towards traditional care were some of the common sociocultural factors hindering immediate access to advanced medical diagnosis and care. Lastly, the delay in referral was one of the most common health system-related problems highlighted in most of the studies. In conclusion, there is an immediate need to improve the knowledge and understanding of Malaysian women towards breast cancer. Mass media should liaise with the cancer specialists to disseminate accurate and up-to-date information for the readers and audience, helping in modification of cultural beliefs that hinder timing health seeking. However, such intervention will not improve or rectify the health system related barriers to treatment seeking. Therefore, there is an immediate need for resource adjustment and training programs among health professional to improve their competency and professionalism required to develop an efficient health system.

Current Status of the Pediatric Palliative Care Pilot Project in South Korea Based on the Experience of a Single Center

  • Sun Hee Choi;Na Ri Yoon;Yeonhee Lee
    • Journal of Hospice and Palliative Care
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    • v.26 no.2
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    • pp.51-59
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    • 2023
  • Purpose: We evaluated the status of patients enrolled in South Korea's pediatric palliative care pilot project based on the experience of a single center. This study examined factors related to end-of-life services and differences in medical costs. Methods: The medical records of 120 patients referred by a pediatric palliative care team were analyzed retrospectively. Data from July 1 to February 28, 2022 were collected and analyzed using the chi-square test and the Mann-Whitney U test. Results: Volunteer programs and psychological support (100%), family support and education (99.2%), and financial support through institutional linkage (62.5%) were provided to the participants. In the deceased group, there were no significant differences in general characteristics, which included age, gender, primary disease, religion, duration of hospitalization in an intensive care unit (ICU) and non-intensive care unit (non-ICU). However, the ICU group had fewer opportunities to access individual pain and physical symptom management than the non-ICU group and there were limitations in linking with external resources. Medical expenses were significantly different for the ICU group, with a 3-times higher average cost than the non-ICU group. Conclusion: Although an individualized approach is needed for each patient in pediatric palliative care, psychosocial care is essential. In addition, if early intervention for end-of-life pediatric patients is available from a palliative care team, the cost burden of medical care for patients and their families should be minimal.

Medical Experiences and Unmet Health Care Perception among Elderly People with Chronic Disease (만성질환을 가진 노인의 의료경험과 미충족의료 인식)

  • Min, Dong-Hoo;Cho, Jung-Yeon;Kim, Jeong-Gil;Seo, Su-Jin;Kim, Mi-Kyung;Shim, Eun-Hye;Cha, Yu-Hyun;Kim, Chang-Yup
    • Health Policy and Management
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    • v.28 no.1
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    • pp.35-47
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    • 2018
  • Background: The purpose of this study is to elucidate the context of medical experience and the perception of unmet healthcare of elderly people with chronic diseases based on in-depth interview data. Methods: We carried out in-depth interviews with 10 elderly people with chronic diseases using semi-structured questionnaires based on literature review. The in-depth interview data were analyzed using thematic analysis; one qualitative research methodology, three core meaning categories, and four attributes associated with unmet healthcare were ultimately derived. Results: The context of the medical experience were based on the following three categories: (1) discomfort due to diseases and high medical needs, (2) the poor community medical environment and difficulties in accessing to metropolitan medical institutions, and (3) inconvenience caused by long waiting time and side effects of medicine. In addition, the elderly with chronic disease realized the unmet healthcare as (1) the availability related to the desired medical institutions at the right time, (2) the affordability related to their economic capacity, (3) the effectiveness of the medical services they experienced, and (4) the appropriateness related to receiving medical services in a pleasant environment. Conclusion: The perception of unmet healthcare among the elderly with chronic disease is the result of interaction of multi-level and multi-dimensional factors related with their medical experience.

Research on Geographic Variations in Health Services Utilization in the United States: A Critical Review and Implications (미국의 지역간 의료이용의 변이 연구: 비판적 검토와 함의)

  • Do, Young-Kyung
    • Health Policy and Management
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    • v.17 no.1
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    • pp.94-124
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    • 2007
  • This paper critically reviews three decades of research on geographic variations. in health services utilization in the United States, thereby drawing policy and research implications for Korea. The recent renewed interest in variations research in the United States, precipitated by studies on regional variations in Medicare expenditures, stems mainly from the policy implication that a substantial amount of Medicare expenditures could be saved without compromising quality and access. From the research perspective, this policy implication was made tenable by integrating micro- and macro-level analysis of variations in health services utilization. Still, theoretical limitations inherent in the research pose great challenges to developing effective strategies at the health system level. Variations research in the United States can serve as a case study as to how health services research has responded to efficiency and quality issues in an ever expanding health system Considering the current health policy and research environment in Korea, the following implications can be drawn. Variations research will help formulate a national policy agenda for health care quality and also advance the framework of approaches to health policy issues. For such purposes, both relevant descriptive and hypothesis-testing studies are needed. Further advancement in variations research will require interdisciplinary explorations and methodological sophistication. To the extent that Korean health policies will strive to achieve complex goals, variations research will increasingly prove to be useful.

Design of Open Gateway Framework for Personalized Healing Data Access (개인화된 힐링 데이터 접근을 위한 개방형 게이트웨이 프레임워크 설계)

  • Jeon, YoungJun;Im, SeokJin;Hwang, HeeJoung
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.15 no.1
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    • pp.229-235
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    • 2015
  • ICT healing platform is based on bio-signal and life habit information target to alarm early sickness concept prevention chronic pain. ICT(Information & Communication Technology) healing platform target on personal lead health management care of several health agencies and open of the (hospital, fitness center, health examination center, personal health device) personal health information together to personal device. Support Analysis Platform and Open API to vitalization optional services. In this paper proposal to access personality healing data Open Gateway Framework of Healing Platform Adaptor (HPAdaptor) ICT healing platform means Data relaying link to EMR(Electronic health record), korean medicine, life log, wellness, chronic pain, and fineness several personal health data provider and service provider personal healing data with software engine. After Design HPAdaptor can use for data and service provider record storage, mobile platform and analytics platform need data service or platform relying reference model.

Stakeholder Survey on the Incentive Program to Promote the Adoption of Health Information Exchange (진료정보교류 인센티브사업에 대한 이해관계자 조사연구)

  • Park, Hayoung;Ock, Minsu;Park, Jong Son;Lee, Hye Rin;Kim, Soomin;Lee, Sang-il
    • Journal of Information Technology Services
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    • v.16 no.3
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    • pp.17-45
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    • 2017
  • Health Information Exchange (HIE) is expected to improve the quality and efficiency of care by allowing providers online access to healthcare information generated by other providers at the point of care. However, the adoption of the technology in Korea has been slow since its pilot program in 2007~2010 at Seoul National University Bundang Hospital. The objective of this study was to survey stakeholders on the incentive program for the facilitation of HIE adoption. We surveyed 39 experts representing 6 categories of stakeholders-provider, insurer, government, information service firms, customers, and medical informatics experts for the interviews. Interview questions included program objectives, program participation requirements, incentive payment method, and administrative burden for program participation. Experts indicated that the quality of care was the most important value the program should aim to achieve through the HIE adoption. They suggested that the requirements and administrative burden for participation should be kept at minimum to recruit a large number of providers to the program, which is an indicator of program success. Experts were divided on the payment method whether the incentive should be paid as a part of the fee payment scheme operated by the National Health Insurance (NHI) or should be a payment made independent of the NHI. The source of the divide was conflict of interest among stakeholders as to who pays for the program, and the insurer and consumer groups were against the NHI taking the financial burden. It appeared to be the most significant factor for the successful program launching to resolve the gap in perceptions about benefits of the technology among stakeholders and to win the willingness to pay for the program.