• 제목/요약/키워드: Community health management

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비용편익분석을 이용한 일 재가노인간호센터의 고혈압 및 당뇨관리 효과평가 (An Evaluation of Effects on Hypertension and Diabetes Mellitus Management of a Community-Based Nursing Care Center Using Cost-Benefit Analysis)

  • 임지영;임정남;김인아;고수경
    • 간호행정학회지
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    • 제16권3호
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    • pp.295-305
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    • 2010
  • Purpose: This study was conducted to evaluate the economic efficiency of a community-based nursing care center to help policy makers determine whether or not to invest in similar facilities. Methods: The subjects were 101 elderly people over 65 years who participated in a health management program from February 1 to July 31, 2007. Direct cost was estimated with center operations cost, medical cost for out-patients and pharmacy cost. Indirect cost was measured by transportation cost. Direct benefit was calculated by saved medical cost for out-patients, saved pharmacy cost, saved transportation cost, and reducing hospital charges. Indirect benefit was estimated with prevention of severe complications. Economic efficiency was evaluated by cost-benefit ratio and net benefit. Results: Operating a community-based nursing care center was found to be cost-effective. Specifically, the cost of operating the center evaluated here was estimated at 135 million won while the benefit was estimated at 187 million won. Benefit-cost ratio was 1.38. Conclusion: The Community-based nursing care center that was described here could be a useful health care delivery system for reducing medical expenditures.

강유역의 간흡충 감염양성자를 위한 사례관리 적용효과 (The Effects of Case Management for Clients with Clonorchiasis in Riverside Areas)

  • 김춘미;김희걸;전경자;김숙영
    • 지역사회간호학회지
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    • 제23권4호
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    • pp.427-437
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    • 2012
  • Purpose: In order to lower the infection rate and the reinfection rate of Clonorchiasis in high-risk areas, we performed and analyzed a case management on people with chlonorchisis. Methods: The data was collected from April 2010 to March 2011. A community health practitioner was selected as a case manager based on our training program. The intervention group had 58 participants with three months of case management and the control group had 144 participants handled with traditional methods. Results: the pre and post-test in the intervention group and the control group showed us improved knowledge of Clonorchiasis, attitudes and behavior toward eating freshwater fish. The results of post-test between the intervention group and the control group showed statistically significant differences in all categories, except a hand-washing category. However, one year after a case management, there was no significant difference in the failure rate of treatment. Conclusion: The case management was effective for people infected with Clornorchiasis near riverside areas; however, in order to lower the rates of reinfection and treatment failure, it is necessary to perform continuous monitoring and regular evaluations.

지푸라기 자가관리 프로그램의 적용 효과: 노인의 건강증진을 중심으로 (A Chronic Disease Self-management Program for the Elderly in Korea)

  • 박지원;유혜라
    • 지역사회간호학회지
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    • 제16권4호
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    • pp.404-414
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    • 2005
  • Objectives: The present study proposed to evaluate 1st-month and 3rd-month health status, depression, self-efficacy and medical expenses of a community-based health promotive self-management program for old Koreans. Method: Participants in the CDSMP were selected from elders in a community health center through convenient sampling. The program included a 3-hour session per week for 14 weeks. Outcomes of evaluation in the 1st month and the 3rd month included modified Self-rated Health Status Scale, Center for Epidemiologic Studies Short Depression Scale, Self-Efficacy for Managing Chronic Disease 6-item Scale, and 1-item Medical Expenses Scale. Results: Self-rate health scores increased significantly just after the intervention (16.22), in the 1st month (17.57) and in the 3rd month (19.04) (x2=32.06. p=.000); Depression scores (reversed) also increased significantly just after the intervention (6.04), in the 1st month (7.75) and in the 3rd month (8.39) ( $x^2=29.92$. p=.000); Self-efficacy score increased significantly just after intervention (12.87) but it decreased in the 1st month (12.73) and in the 3rd month (12.04). But all of the three scores were still higher than those before the intervention (8.65) ($x^2=32.42$. p=.000): Medical expense score decreased at the end of the intervention (1.57) but the cost score increased in the 1st month (2.48) and in the 3rd month (2.39) ($x^2$=7.81. p=.050). Conclusion: CDSMP is effective in increasing self-rate health and self-efficacy and in decreasing depression in the Korean elderly. However, no significant effect of the program was observed in decreasing the medical cost of the Korean elderly.

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지역사회 여성 독거노인을 위한 '스스로 관절관리' 프로그램의 적용 효과 (Effect of the Arthritis Self-management Program on Elderly Women Living Alone in the Community)

  • 조무용;김대숙
    • 근관절건강학회지
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    • 제31권1호
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    • pp.1-11
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    • 2024
  • Purpose: This study aimed to evaluate the effects of an arthritis self-management program on elderly women living alone in the community. Methods: This study recruited 36 individuals, who participated in the program once a week for six weeks at two community centers. The program consisted of muscle strengthening and flexibility exercises, health education on muscles and joints, and joint dance for aerobic exercise. The data collected were analyzed using the paired t-test and Wilcoxon rank test. Results: After six weeks, participants showed significant improvements in pain (t=3.03, p=.005), difficulties in activities of daily living (t=2.77, p=.010), health-related quality of life (t=-2.63, p=.014), flexibility of right shoulder (z=-2.42, p=.015), and balance (right leg, t=-2.63, p=.036; left leg, z=-2.36, p=.018). Conclusion: The results showed that the arthritis self-management program effectively improved outcomes for elderly women living alone. Thus, this program could be incorporated into various programs for elderly people living alone.

개인 및 사회적 관계특성과 지역사회만족이 성인 유산소 신체활동에 미치는 영향 (The Effects of Personal and Social Relationship Characteristics and Community Satisfaction on Aerobic Physical Activity in Adults)

  • 백은혜;이현실
    • 한국학교ㆍ지역보건교육학회지
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    • 제24권4호
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    • pp.13-26
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    • 2023
  • Objectives: The purpose of this study was to explore the factors that influence aerobic physical activity among Korean adults, including sociodemographic characteristics, health behavior, health status, social relationships, community satisfaction, and to find ways to increase aerobic physical activity among adults. Methods: In 2019, 191,152 adults in the Community Health Survey were analyzed, and complex sample frequency analysis, Rao-Scott test and complex sample logistic regression analysis were conducted by dividing them into the presence or absence of aerobic physical activity practice. Results: The rate of aerobic physical activity among adults was 36.0%, and males were higher than females. Among individual factors, gender, age, income level, smoking, drinking, weight control attempt, frequency of breakfast, obesity, quality of life, and subjective health status were factors that had a significant effect. Among social relationship factors, leisure activities and contact with neighbors at least once a week were significant factors, and only overall safety level satisfaction was a factor that had a significant effect on physical activity practice in community satisfaction factors. Conclusion: Programs focused on personal factors, social relationships, and networks should be strategically developed to improve the participation rate of adult aerobic physical activities, indicating the importance of these factors over community infrastructure. To development of community-centered professional integrated health education will be necessary in the future.

지역사회 노인의 약물복용실태와 약물관리 프로그램의 효과 (Medication Status and the Effects of a Medication Management Education Program for the Elderly in a Community)

  • 박영임;이강이;김동옥;엄동춘;김지현
    • 지역사회간호학회지
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    • 제25권3호
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    • pp.170-179
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    • 2014
  • Purpose: This study investigated medication status by examining the effects of a medication management education program on the knowledge of medications and medication misuse behaviors in the elderly in a local community. Methods: This study used a non-equivalent control group quasi-experimental design. For the study, 116 subjects were assigned to the control group and another 116 subjects were assigned to the experimental group. The medication management education program consisted of 1:1 education, practice in medication management, consultation, and discussion. Data were analyzed using the SPSS 21.0 program. Results: Statistically significant differences were found between the experimental and control groups in terms of their knowledge of medications and medication misuse behaviors. Conclusion: The results indicate that the medical management education program is effective in improving the knowledge of medications and decreasing medication misuse behaviors. Therefore, this education program can be used as an intervention to improve the medication behaviors of the elderly in local communities.

The Nutrition Assessment and Care for the Elderly in Japan

  • Sugiyama, Michiko;Nishimura, Akio;Koyama, Hideo
    • Journal of Community Nutrition
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    • 제2권1호
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    • pp.12-26
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    • 2000
  • In Japan, a new nursing insurance system was enforced in April 2000, where premiums were paid according to the level of necessary care. Our project, Nutrition Care and Management(NCM) for the elderly was started in 1995, funded by the Ministry of Health and Welfare of Japan. The NCM project was to provide appropriate nutrition care for the elderly and to see that it effectively functions as part of the health care services. There were 4 stages to the project : the first stage was to find out the PEM status among the elderly patients in hospital and home-care settings in Japan. The 2nd stage was to develop and evaluate nutritional assessment methods, anthropometry, resting energy expenditure measuring methods using of portable indirect calorimeter, and the convenient protein energy intake assessment methods, etc. for the elderly patients with PEM risk. The 3rd stage was to examine the effectiveness of the nutrition care plan induced of protein energy supplement and team care in improving nutrition among the elderly patients. The last stage was to develop the NCM set for the elderly patient based on the past three years of scientific evidence. it is expected that the NCM system for the elderly will provide adequate nutritional care management, improve the elderly care environment and create effective resource management.

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보건진료소 보건사업 현황 분석 (Analysis of the Results of Health Service Programs in the Primary Health Care Posts)

  • 손계순;문자;박춘희;이은경
    • 한국농촌간호학회지
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    • 제3권1호
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    • pp.24-33
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    • 2008
  • Purpose: To analyze health programs of the PHCP (Primary Health Care Posts) Method: From August 2006 to July 2007, data on the general quality and health program of the PHCP was requested by official letter and replies were received via E-mail. From December 8 to December 30, 2007, data from 1,268 (66.8%) PHCP out of 1,897 PHCP were analyzed using SPSS 12.0 Win program. Results: The average population covered by each PHCP is 878.3 people. For the health and special programs, Community Health Practitioners report high motivation for programs on health promotion, management of chronic illness, social welfare (40-50%). Demand by the residents was reported at 10% and increases in the health of the residents were attributed to high interest and demand. Volunteer work was 83.3% for bathing, 54.5% for equipment support and 46% for exercise programs. As elders make up 30% of the population in rural areas, there is an increasing demand for volunteer work in bathing programs. Conclusions: As the number of elders in the population increases and there is an increased need for more medical treatment for older people who are sick, the role of PHCP must be strengthened to include visits to homes of community residents. Where financial support for the PHCP is difficult, it is necessary to develop sound data on demographic characteristics of the population in order to develop efficient and effective health promotion programs. The finding that 54.7% of the population need management of chronic illness has difficulty in seeing a physician indicates a need to enhance the health care delivery system by strengthening the role of the Community Health Practitioners and including them in the civil service system to ensure stability of the PHCP.

재가장기요양기관의 방문구강보건교육 전·후 의치의 일부 병원성 미생물의 집락수 변화 (Home visiting oral health program of Longterm home care service and the change of some pathogenic microorganism counts in denture)

  • 한지혜;배성숙
    • 한국학교ㆍ지역보건교육학회지
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    • 제20권3호
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    • pp.83-90
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    • 2019
  • Purpose: This study is a repetitive comparative analysis of a qualitative case study that carried out a home visiting oral health education program. Method: This study conducted an interview survey through medical examination by interview before and after the home visiting oral health education and measured some pathogenic microorganism counts in the denture. Results: There was a positive change in the self oral care ability of the elderly at home after home visiting oral health education, including the behavior of self management of dentures, and some pathogenic microorganism counts in the dentures. Conclusion: The home visiting oral health education of home care service centers can improve oral health care for the elderly at home.

서울시 보건소 방문간호 수요.공급 추계 (An Estimation on the Need and Supply for Visiting Nursing Services of Health Center in Seoul)

  • 명재일;황라일;유호신
    • 지역사회간호학회지
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    • 제14권4호
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    • pp.587-597
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    • 2003
  • Purpose: The purpose of this study was to estimate the demand and supply of visiting nursing services provided by health centers in urban area, aiming at strengthening infrastructure, which may improved the quality of life and health status of vulnerable population in the community. Methods: This study was conducted through nominal group discussion, focus group study. The demand and supply of visiting nursing were estimated by health economists based on the secondary analysis data from 25 health centers in Seoul. Result: Primary targets for the visiting nursing must be people who are homebound in the community. They can be classified into: a group of Level I: chronic patients who need visiting nursing care at least once a week: and a group of Level II: vulnerable families that need management periodically e. g. twice a month. Based on the estimation of demand for visiting nursing services in the community, the estimated supply required was $651{\sim}770$ visiting nurses including home health nurses in visiting nursing programs based on health centers in Seoul. Conclusions: The estimated demand and supply of visiting nursing are expected to provide basic data for establishing alternative policies on visiting nursing infrastructure that might be accomplished through demand-based visiting nursing programs by districts.

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