• 제목/요약/키워드: Community health care

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델파이법을 이용한 일차의료 개념정의: 이차출판 (Defining the Concept of Primary Care in South Korea Using a Delphi Method: Secondary Publication)

  • 이재호;최용준;;김수영;김용식;박훈기;전태희;홍승권
    • 보건행정학회지
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    • 제24권1호
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    • pp.100-106
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    • 2014
  • Background: There is no consensus on the definition of primary care in South Korea. This study's objective was to define the concept of primary care using a Delphi method. Methods: Three expert panels were formed, consisting of 16 primary care policy researchers, 45 stakeholders, and 16 primary care physicians. Three rounds of voting, using 9-point appropriateness scales, were conducted. The first round involved rating the appropriateness of 20 previously established attributes of primary care. In the second round, panelists received a summary of the first-round results and were asked to once again vote on the 10 undetermined attributes and the provisional definition. The final round involved voting on the appropriateness of the revised definition. The Korean Language Society reviewed the revised definition. Results: Four core (first-contact care, comprehensiveness, coordination, and longitudinality) and three ancillary (personalized care, family and community context, and community base) attributes were selected. The Korean definition of primary care was accomplished with all three panel groups arriving at a 'very good' level of consensus. Conclusion: The Korean definition of primary care will provide a framework for evaluating performance of primary care in South Korea. It will also contribute to resolving confusion about the concept of primary care.

연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査) (A Basie Health Survey of the Yonsei Community Health Service Area, Seoul)

  • 양재모;김명호
    • Journal of Preventive Medicine and Public Health
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    • 제1권1호
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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재가 취약계층을 위한 지역사회 중심 가정간호서비스의 경제적 효과 (Economic Effect of Home Health Care Services for Community-dwelling Vulnerable Populations)

  • 이은희;김진현
    • 대한간호학회지
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    • 제46권4호
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    • pp.562-571
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    • 2016
  • Purpose: In this study the costs and benefits of a home health care program were examined to evaluate the economic feasibility of the program. Methods: The study participants included 349 patients in the community who had been registered at a home health care center for 5 years. The costs and benefits of the program were analyzed using performance data and health data. The benefits were classified as the effects of pressure ulcer care, skin wound care and catheters management. The program effect was evaluated on the change of progress using transition probability. Benefits were divided into direct benefit such as the savings in medical costs and transportation costs, and indirect benefits which included saving in productivity loss and lost future income. Results: Participants had an average of 1.82 health problems. The input cost was KRW 36.8~153.3 million, the benefit was KRW 95.4~279.7 million. Direct benefits accounted for 53.4%~81.2%, and was higher than indirect benefits. The net benefit was greater than 0 from 2006 to 2009, and then dropped below 0 in 2010. Conclusion: The average net benefit during 5 years was over 0 and the benefit cost ratoi was over 1.00, indicating that the home health care program si economical.

보육시설의 건강검진 현황에 관한 조사연구 (A Survey on the Health Examination of Child Care Centers)

  • 김일옥;강란혜
    • Child Health Nursing Research
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    • 제11권3호
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    • pp.308-315
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    • 2005
  • Purpose: This descriptive study was conducted to examine the status of the health examination in child care centers. Method: The participants in this study were 631 child care centers. A self report questionnaire on health examination which has been examined for content validity, was distributed by mail to 2,000 child care centers using randomized sampling. Result: Of the sample, $76.2\%$ child care centers had done health examination for children. Height & weight, urinalysis, dental check, anemia test and visual acuity were the most frequently performed items. The rate for maintaining a health record was highest in the national/public child care centers. Child care centers more closely related to community health centers, showed higher rates of health examination. Conclusion: Health care personnel and financial aids should be provided for child care centers to enhance the level of health management of children.

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노인보건의료 관리모형 (A. Model for the Elderly Health Care Management)

  • 이선자
    • 한국보건간호학회지
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    • 제8권2호
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    • pp.71-82
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    • 1994
  • The article reviewed the elderly health care management problems in policy development issue of the nation. Policy of Korean government on elderly health care has still not yet developed. The main stream of policy which is effective on elderly welfare policy is 'Elderly care are responsible by their families'. Now only those aged whose family members are not able to take care of their parents are receive custodial care at the non-profit nursing homes. This article examined the main stream policy in pro and cons aspects in relation to social changes such as: demographic changes. family structure changes. attitude changes. health care delivery system. and political settlement view points in connection with medical insurance program. Finally. a model for the elderly health care management was proposed which will provide chronic care services at the community level. such as nursing homes. day care centers. day hospitals, respite care units, and special care institute for dementia.

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보건진료원들이 지각하는 보건진료소 30년간의 활동경험과 성과 (Looking Back the Past 30 Years: Activities and Achievements of Community Health Practitioners in Rural and Remote Areas in Korea)

  • 김춘미;전경자
    • 지역사회간호학회지
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    • 제23권1호
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    • pp.51-62
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    • 2012
  • Purpose: The purpose of this study was to identify community health nursing activities that community health practitioners perceive and their achievements in community by reviewing the community health nursing activities that community health practitioners have done for the last 30 years. Methods: This study was a qualitative study. Thirty one community health practitioners were interviewed using the focus group interview method and data were analyzed using content analysis. Data were collected from April to June in 2011. Results: Community health practitioners perceived themselves as "Community Vitalizers" and 9 categories were identified. They were 'ground to explore new nursing areas', 'assimilation to community', 'ground to establish community diagnosis', 'everyday life health management in the community', 'increased accessibility to medical services for the residents', 'enforced health practices for the residents', 'reinforced self-reliance of community', 'commitment to making a happy village' and 'mental fence of the community.' Conclusion: This study was meaningful in that it explained the unique identity of the community health practitioners and could be used as important basic materials in the process of re-establishment of the roles of Health Offices. Hereafter in-depth study on community competence reinforcement should be made to identify the roles of community health nurses.

여성건강 간호센터를 위한 모형개발 - 일개 통합시를 중심으로- (Model Development a Womens' Health Care Center in the Community)

  • 이은희;소애영;최상순
    • 대한간호학회지
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    • 제30권5호
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    • pp.1195-1206
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    • 2000
  • The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.

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재가노인의 자아존중감, 자가간호와 생활만족도간의 관계 (The Relations between Self-esteem, Self-care and Life Satisfaction in the Home-dwelling Elderly)

  • 김봉임
    • 지역사회간호학회지
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    • 제16권4호
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    • pp.415-423
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    • 2005
  • Purpose: The present study was conducted to identify the relations between self-esteem. self-care and life satisfaction in the home-dwelling elderly. Methods: The subjects were 106 persons aged over 65 in J city. Data were collected from April to June 2005 by a questionnaire survey. The instruments used in this study are the self-esteem scale developed by Rosenberg(1965), the self-care scale by Hwang (2000) and the life-satisfaction scale by Choi (1986). Data were analyzed through t-test, ANOVA. least significant difference, Pearson's correlation coefficient and stepwise regression analysis using SPSS-Win 10.0. Results: Self-esteem and self-care were in a positive correlation with each other (r=.464, p=.000). Self-care and life-satisfaction showed a significant correlation with each other (r=.222 p=.031), and a significant correlation was found between self-esteem and life-satisfaction (r=.506, p=.000). The most significant predictors influencing life-satisfaction were self-esteem, self-care and perceived health condition, and the three factors accounted for 47.7% of variance in life satisfaction in the home-dwelling elderly. Conclusion: These results suggest that self-esteem, self-care and life-satisfaction can be important factors the quality of life of the elderly in long-term care. Therefore nurses can plan nursing interventions to promote self-esteem, self-care and life satisfaction of the home-dwelling elderly.

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RAI(Resident Assessment Instrument)를 이용한 노인가정간호 및 재가복지서비스 정보시스템 개발 (Development of a Database System for Home Care Service Based on RAI (Resident Assessment Instrument))

  • 전경자;김은영
    • 지역사회간호학회지
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    • 제14권1호
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    • pp.75-82
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    • 2003
  • The purpose of this study was to develop an information system for home care service based on RAI(Resident Assessment Instrument). The standardization of service providing process was conducted using the steps of need assessment, triggers, application of CAPs, and care plan. The structure of MDsoft-HC was composed by MDS-CAPS system and system management system. A database on home care clients was accumulated by putting data, respectively, in general information, MDS-item, and MDS-result. Based on this data, the list of CAPs for the client was selected and monthly and annual statistics were calculated by problem result counts. It was suggested that standardization of a care plan would be integrated and short form of need assessment would be developed in the next stage.

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