Purpose: This study was conducted to understand public perception of home-based hospice and identify related factors. Methods: Between August 19, 2014 and August 30, 2014, data were collected using an E-mail questionnaire that was filled by 1,500 adults who were over 20 years of age. Data were analyzed using descriptive statistics, ${\chi}^2$-test and logistic regression. Results: Among the respondents, 15.9% were aware of home-based hospice care, and 61.3% were willing to receive home-based hospice care. The factors that influenced the participants' willingness to use home-based hospice services included residential district, religion and private health insurance. Respondents who lived in Seoul (OR: 1.56, 95% CI: 1.04~2.33), Gwangju/Jeolla province (OR: 2.02, 95% CI: 1.23~3.32), Busan/Ulsan/South Gyeongsang province (OR: 1.81, 95% CI: 1.17~2.82) were more well-aware of home-based hospice care than those who lived in Incheon/Gyeonggi province. The faithful were more informed about the services than those without non-faithful participants (Roman Catholics (OR: 2.03, 95% CI: 1.30~3.17), Protestants (OR: 1.76, 95% CI: 1.22~2.53). Participants who had a private health insurance plan knew more about the services than those without one (OR: 1.45, 95% CI: 1.03~2.04). Conclusion: First, it is necessary to improve perception of the public and healthcare providers regarding home-based hospice care. The government should review a measure to institutionalize operation of a palliative care team at hospitals and community home-based hospice care centers.
Journal of agricultural medicine and community health
/
v.49
no.2
/
pp.132-145
/
2024
Objectives: This study compares cases of Dalgubeol Health Care Project, 301 Network Project, and 3 for 1 Project based on program logic models to derive measures for promoting integrated healthcare and welfare services centered around medical institutions. Methods: From January to December 2021, information on the implementation systems and performance of each institution was collected. Data sources included prior academic research, project reports, operational guidelines, official press releases, media articles, and written surveys from project managers. A program logic model analysis framework was applied, structuring the information based on four elements: situation, input, activity, and output. Results: All three projects aimed to address the fragmentation of health and welfare services and medical blind spots. Despite similar multidisciplinary team compositions, differences existed in specific fields, recruitment scale, and employment types. Variations in funding sources led to differences in community collaboration, support methods, and future directions. There were discrepancies in the number of beneficiaries and medical treatments, with different results observed when comparing the actual number of people to input manpower and project cost per beneficiary. Conclusions: To design an integrated health and welfare service provision system centered on medical institutions, securing a stable funding mechanism and establishing an appropriate target population and service delivery system are crucial. Additionally, installing a dedicated department within the medical institution to link activities across various sectors, rather than outsourcing, is necessary. Ensuring appropriate recruitment and stable employment systems is needed. A comprehensive provision system offering services from mild to severe cases through public-private cooperation is suggested.
Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get information about the diet therapy (12.21%) and not having one (26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian's inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.
Journal of agricultural medicine and community health
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v.25
no.1
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pp.99-112
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2000
This survey was conducted to assess the utilization of health center including health sub-center and community health post and the health service demand of residents in a urban and rural unified community. Officials in Up·Myun·Dong offices visited randomly sampled 4,027 households(4.6% of total households in unified City) which included 3,337 households in urban area(4.9% of total households) and 690 households in rural area(3.7% of total households) and interviewed with heads or housewives of the households in September, 1995. There were significant differences in health-related demographic characteristics including age-sex distribution, educational level, period of residence in the community and medical insurance status of the interviewees between urban and rural areas. Of the respondents, 64.8% in urban area and 55.6% in rural replied that they had utilized the health center in the past. The most common purpose for visiting the health center was to get vaccination in urban area and to get outpatient care in rural area. The top priority health center activity that needs to be reinforced was communicable disease control and over 90% of the respondents preferred to have mobile clinic and home health care service in were also highly demanded. Eighty-six percent of the urban respondents replied that a health sub-center must be established in urban area. In the rural area, 90.3% of the respondents replied that they wanted to maintain the health sub-center and 88.3% wanted to maintain the community health post. Along with the improvement of facilities and equipments of the health center by Rural Health Service Improvement Project, new health service programs must be developed to meet the demand of the community.
Journal of the Korea Institute of Information and Communication Engineering
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v.17
no.11
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pp.2693-2698
/
2013
As our country is currently facing "aging society," people demands for qualitively and quantitatively better social welfare services. In particular, the abruptly rapid increase in the elderly population requires various welfare services and medical care related to the elderly. It is urgent to resolve these demands. Also, IT technology in Korea is developing rapidly, and U-Health, a part of the Ubiquitous field is under the actively ongoing researches. In this paper, we studied the Elderly care system model suing U-Health technology. We designed the care system of the residential environment designed specific for the elderly. Additionally, based on that design, we studied the elderly care system using the ubiquitous technology. Since this elderly care system combines the existing community-based model and IT technology in conjunction with other mobile devices, we may supply a new care service application, thus solving the problems of the existing care and medical services.
Journal of agricultural medicine and community health
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v.28
no.1
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pp.67-77
/
2003
Objectives: This study is designed to suggest the health service goals necessary for providing the more efficient services relevant to the requests of the community, through the evaluation on the operating status of the unified health subcenters. Methods: We visited total 5 unified health subcenters comprising 3 ones located in Gyeongsangbuk-do and 2 ones located in Gyeongsangnam-do from December 2000 to January 2001, and interviewed about the pre- and post-unified status related to manpower, facilities, equipment, medical service and health service quality, and the problems and improvement plans of the unified management. Results: According to the evaluation on the manpower before and after the unification of the health subcenters, the total employees increased by 2.8 persons on average from 6.8 to 9.6 persons in the investigated subjects. The numbers of doctors, dentists and nurses were almost the same as before. There were no clinical pathologic technician and radiological technician before but they were appointed to duty in 3 unified health subcenters later. The unification of the health subcenters has produced slight increases in the frequency of the medical service and dental treatment and considerable increases in that of the physical therapy and laboratory tests. In relating to the changes of the health service, the cases of visiting health care and ambulatory medical service, and the total number of health education participants were greatly increased after the unification. The number of cases undergoing the vaccination and cervical cancer screening was similar to that of the pre-unification while the patient number of the registration to hypertension or diabetes showed a tendency to increase a little. Since the unification of the health subcenters, the frequency of laboratory tests has been increased, but the quality of health service has not been improved yet. Nevertheless, the unification seems to be positive according to the result of the great improvement in visiting health care, ambulatory medical service and health education service. The problems of the unification of the health subcenters were indicated in indefiniteness of the service details between the workers; excessively large building hard to be effectively managed; insufficient medical instruments, inappropriation of working expenses, lack of professional training for the health education, etc. Conclusions: For further active functions of the unified health subcenters, the minimal allocation basis to appoint doctors, nurses and administrative workers to do the duty should be differentiated from the basis for a health subcenter, and the fundamental instruments needs to be expanded to improve the quality of the medical service and visiting health care service. Moreover, the unified health subcenter needs to have definite service details between the workers, and should improve the working efficiency through the development of service-related guidelines.
The purpose of this study was to investigate school dietitians' satisfaction with and needs for School Meal Service Support Centers. A web-based on-line survey was conducted with 1,102 nutrition teachers or school dietitians using four School Meal Service Support Centers during the summer of 2011. The data from 578 respondents (52.5%), consisting of 165 (44.4%), 334 (53.4%), 41 (67.2%), and 38 (86.4%) dietitians using Seoul, Gyeonggi, Suncheon and Gyeongju centers, respectively, were analyzed. The main reason for using the centers was subsidies from local governments. The dietitians using the metropolitan centers, which were Seoul and Gyeonggi centers, tended to buy agricultural products through the centers only, and those using local centers, which were Suncehon and Gyeongju centers, bought those products from the private suppliers as well as from the centers. The dietitians' overall level of satisfaction with the centers was not high showing 3.3 out of 5 points; it was significantly associated with the operating system and services of the centers such as system efficiency, delivery accuracy, communication, and information provision rather than the agricultural products provided by the centers. The dietitians preferred joint operation of the centers by local governments and producers' groups. They wanted School Meal Service Support Centers to be evaluated every year. It was suggested that efforts should be made to improve the operation system and service of School Meal Service Support Centers for improving dietitians' satisfaction with the centers. In addition, an evaluation system for School Meal Service Support Centers should be implemented soon based on school dietitians' needs.
As the socialization of care is progressing rapidly, the necessity of community-level mental health intervention for older adults with severe social isolation and depression is also increasing. In line with the reorganization of the Individualized Support Services for Older Adults in 2020, the social relations revitalization project for the elderly living alone, which had been conducted as a pilot project in 2014~19, was expanded and reorganized into a separate specialized project within the Individualized Support Services for Older Adults. The purpose of this study is to enhance understanding of the specialized service and to clarify its conceptual framework. The characteristics and conceptual framework of the specialized service were examined through a review of the process of institutionalization of the specialized service, which included analysis of related literature and the pilot projects. Finally, it discussed what to consider in order for the specialized service to proceed as intended in the future, focusing on a couple of situations that occur at the fields.
Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen's medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion: The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.
The aim of this study was to identify the impact of community factors on the community-level Health-Related Quality of Life (HRQOL) in Korea. This was a cross-sectional study conducted in 2012 using secondary data(n=209) of the Korean Statistical Information Service. The framework was based on community factors provided by the International Council of Science (ICSU) and community factors were categorized based on six aspects. Multiple regression was applied to community factors depending on the community EQ-5D index. Smoking rate, "Good" self-rated health rate, water and wastewater coverage rate, and financial independency rate were significantly and positively associated with the EQ-5D score. Net migration rate(more move out than move in), obesity rate, unmet needed health care rate, and community type(rural than urban) were significantly and negatively associated with the EQ-5D score. This study identifies association for the impact of community factors on the community-level HRQOL and can provide useful evidence for development of community health promotion policies.
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