Purpose: To examine factors affecting long-term care hospital patients' intention of transfer to a nursing home. Method: A questionnaire survey was conducted in Aug. 2007 that included 655 patients from 49 long-term care hospitals. The survey aimed to assess the patients' health status, family status, cost and intention of transfer to a nursing home. Institutional characteristics were analyzed from the nationwide database of Health Insurance Review & Assessment Service. The affecting factors were examined by employing chi-square test and logistic regression using SAS 8.2. Result: Of the subjects, 32.4% had intention of transfer to a nursing home. The intention of transfer to a nursing home was affected by moderate or severe pain, living together with the primary carer, high cost uncovered by insurance, and recognition of nursing home. Conclusion; For appropriate service utilization. a higher level of care is needed to satisfy patients at nursing homes and a balanced fee schedule is needed between long term care hospitals and nursing homes. It is desirable to encourage transfer to a nursing home at which nurses support patients and their families by giving information, coordination, and to make efforts to establish a reference system.
Purpose: This study examined the definition of care coordination, and the activities and roles of nurse care coordinators. The study also proposed suggestions for establishing and expanding the role of nurse care coordinators in community health practice. Methods: This study derived its conclusions by conducting a literature review. Results: The definition of care coordination is a comprehensive concept that includes case management and transitional care, and can be summarized as organizer and integrator of care. According to the literature review, 12 activities and 6 roles of nurse care coordinator were identified such as a collaborator, an individualized care planer, an educator/counselor, a direct nursing care providers, a population care coordinator, and a program evaluator. Training for nurse care coordinators is currently addressed in the Primary Medical Chronic Disease Management Program. Visiting nurses working at the Eupyeong-dong visiting health and welfare service are expected to act as nurse care coordinators, and the role of nurse care coordinators will, in the future, gradually increase in various nursing facilities. Conclusion: In addition to developing competencies to act as a nurse care coordinator, there is need for approaches to health policy that develop both independent role and population focused role as care coordinators.
The purpose of this study is to review the Home and Community Based Care Program in the United States and to examine the ways these programs help the rural elderly to maintain independent living in their own home in the community instead of moving into the nursing home. First, the overall welfare policy for the aged and service delivery systems in the United States are reviewed. Second, basic assumptions and programs of HCBC are reviewed. Third, using the informations about the elder support program in Madison, Dane County of Wisconsin as a case, various kinds and contents of specific programs are introduced. Applicability of these programs to rural Korea is discussed.
Using data from the 2001 National Long-Term Care Survey database, this study analyzed gender differences in factors affecting caregiver burdens of spouse caregivers in Korea. Multiple regression was used to estimate factors influencing caregiver burdens of caregiving wives and caregiving husbands respectively. The results showed that there was a significant variability in predictors of caregiver burdens of spouses who take care of the impaired elderly. ADL functional status of care recipients and social support were significant for both the caregiving wives model and caregiving husbands model in influencing caregiving burdens. It was noticeable to report that a caregiver's self-rated health status, monthly caregiving expenses, a care recipient's self-rated health status were unique predictors for the caregiving wives model. These findings suggest that it is vital for planners and providers to take gender differences in spousal caregiving into account when designing and formulating community-based long-term care service programs.
Objective: Community pharmacists are frontline health care providers, but have been considered as underutilized professionals on a daily basis. The purpose of this scoping review was to identify information about the impact of the COVID-19 pandemic on community pharmacy services and to evaluate new services that could be applicable. Methods: We searched MEDLINE and EMBASE for studies published up to January 10, 2020. Search terms consisted of keywords relevant to this review, including "COVID-19", "community pharmacy", and "community pharmacist". This review targeted studies of pharmacist services provided by community pharmacies in OECD member countries during the COVID-19 pandemic period. Results: Twenty-seven studies were included in this review. Changes in community pharmacist services due to the COVID-19 pandemic were broadly classified into four categories. First, as the face-to-face services became challenging, various non-face-to-face services were being tried. Second, community pharmacists directly participated in the services to prevent the spread of COVID-19. Third, community pharmacists made efforts to support continuity of care for patients who experienced difficulties due to the reduced professional care as health and medical resources are concentrated in response to COVID-19. Fourth, community pharmacist services were emerging, targeting patients suffering from greater health inequality during the pandemic. Patients expressed high demand and satisfaction for the service of the community pharmacist, and pharmacists reported self-efficacy and professional pride. Conclusion: This study demonstrated that in the era of the COVID-19 pandemic, various community pharmacist services have been tried and received positive evaluations from patients in several OECD countries.
Purpose: The purpose of this study is to examine the status of care-giving for the demented elderly and to find out the need of community in-house care services-day care services, short-term care services, home help services, and home care services. Method: It analyzed the data of 186 old people having dementia, and caregivers. Data were collected for five days, in September 2002. Results: The caregivers were mostly women and the burden for the care giving was high (87.5%). They used community care services, that is, day care services (26.5%), home care services (21.6%), home help services 00.8%), short-term care services (6.2%). Caregivers' age and education level were significant factors in the demand for day care services. Caregivers' education level was a statistically significant factor in the demand for short-term care services and home help services. Caregivers' age and education level were significant factors in the demand for home care services. Conclusions: It is necessary to expand the financial aid for the active implementation of daytime protection for dementia-patients under medical treatment at home and to promote patients' recovery. It is necessary to enhance home help services and home care services, and to establish many day care centers and short term care centers. Through this, it will prevent caregivers from becoming burnt out due to the burden of care giving.
Elderly people want to live in the community even if they are in poor health. However, there is no integrated care support system suitable for the health and functional status of the elderly. So the elderly are choosing living facilities. The purpose of this study is to explore exploring whether the elderly are applying for a long-term care certification. First, mild geriatric patients were mainly using home care services such as visitation care. However, some of the milder elderly were enrolled in nursing homes. And the service that does not fit the functional status of the elderly is used. Second, it is concentrated on the use of visiting care services. Third, elderly people outside the class did not receive sufficient help for daily life, and the use of community welfare services such as the elderly welfare center was low. As a result, long-term care admitters are not able to continue to live in the community even though their health and functioning status is mild, and elderly people out of grade are unable to properly use the necessary community care services. The condition is likely to deteriorate.
The Journal of Korean Society for School & Community Health Education
/
v.12
no.2
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pp.113-127
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2011
Background: University health services have provided comprehensive medical care, counseling, health promotion, and public health services to their students and several other local institutions. To their faculty and staff, university health care centers have served occupational health services and employee assistant program. Purpose: We performed this study to review the health promotion services on two kinds of health care center with different style of university formate. Methods: We tried to collect the data by literature review and interview with executive and provider at health care center in University of California at Berkeley and San Jose State University. Results: Our results were as followed. First, students could use the medical services just as they would their regular doctor's office and urgent care center. Second, the health promotion unit offered programs and services for keeping students healthy and safe, including many opportunities for students to get involved in shaping the public health of the campus. Third, the health promotion recommendation offered from ACHA was useful guideline to improve health status of their member in university campus. Finally, the student satisfaction surveys were used for evaluation and quality improvement. Conclusions: The systematic approach to improve health status of students, faculty and staff can use to maintain a state of optimum health among the diverse student community in support of academic excellence. Coupled with health promotion and public health programs, university health service have to reach all segments of the healthy campus community. To achieve study goals in university, the health care center contributes to promote accountability and responsibility for the health and well being of the members in their campus.
Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.
The Journal of Korean Society for School & Community Health Education
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v.24
no.3
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pp.37-50
/
2023
Objectives: The aim of this study was to identify factors influencing communication satisfaction between geriatric caregivers and older adults in urban-rural complex communities. The ultimate goal was to design local community educational programs and policies to enhance communication satisfaction among geriatric caregivers and improve the quality of care services for older adults. Methods: To identify factors influencing communication satisfaction between elderly caregivers and older adults, a survey titled "CCEP: Assessment of Communication Status between Elderly Care Service Providers and Recipients" was conducted from February to July 2020, focusing on rural-urban complex areas. The survey was administered based on providers of elderly healthcare services. The survey targeted 131 respondents involved in providing care services for older adults. The dependent variable of this study was the communication satisfaction reported by elderly caregivers in their interactions with the elderly. The independent variables included perceptions of older adults, factors associated with communication difficulties, and communication efforts. Additionally, gender, working environment, working experience, and the proportion of face-to-face interactions with older adults during caregiving were controlled for the hierarchical multiple regression analysis. Results: The analysis revealed that communication efforts with older adults significantly influenced communication satisfaction (β=.09, p<0.01). However, perceptions of the elderly and communication hindrance factors did not have a significant impact on communication satisfaction among geriatric caregivers. Conclusion: Effective communication between geriatric caregivers and older adults is crucial for identifying and meeting the needs and demands of caregiving services, and it plays a vital role in overall caregiving service satisfaction. To enhance communication skills and satisfaction among geriatric caregivers and ensure the appropriate fulfillment of elderly care needs in the local community, the development of community-centered, specialized health communication programs and other initiatives will be necessary in the future.
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