• 제목/요약/키워드: Community health management

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공공 빅데이터를 이용한 치매 노인 사망장소의 결정요인: 지역보건의료자원의 영향 (Impact of Community Health Care Resources on the Place of Death of Older Persons with Dementia in South Korea Using Public Administrative Big Data)

  • 임은옥;김홍수
    • 보건행정학회지
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    • 제27권2호
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    • pp.167-176
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    • 2017
  • 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.

노년기 건강을 위한 만성질환 관리지표 개발 (Indicators for Chronic Disease Management of Older Persons)

  • 백경원;전기홍
    • 한국학교ㆍ지역보건교육학회지
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    • 제15권3호
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    • pp.1-15
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    • 2014
  • Objectives: This study was performed to develop the indicators for national surveillance of chronic disease, which is a governmental concern to manage the chronic disease for older persons. It is necessary that chronic disease surveillance system needs to be made in Korea for effective management of chronic diseases. With the system, we know the prevalence and incidence of chronic diseases, observe the trend of utilization for caring the chronic diseases, and analyze the behavior change for prevention of chronic diseases. Methods: This study was carried out by analyzing the data by which the indicators was produced, by reviewing how the United States made the indicators. By benchmarking the United States, the sources of data of the national surveillance indicators for chronic diseases in Korea were compared. Results: In this study, the most significant indicators were identified and proposed to improve the surveillance indicators by changing the sources of data. These findings warrant further development of the health policy for the chronic disease prevention and establishment of the chronic disease surveillance system. Conclusions: The results of this study can be used to develop national surveillance indicators to manage the chronic diseases and can be used as basic data to develop community health programs.

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대도시지역 동단위 지역담당 방문간호소서비스 효과분석 - 뇌졸중 환자를 대상으로 - (An Evaluation of the Visiting Nursing Service Model Based on the District Management System - focused on stroke patients -)

  • 유호신;황라일;진달래;석민현
    • 지역사회간호학회지
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    • 제16권1호
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    • pp.5-12
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    • 2005
  • Purpose: This study was conducted to examine the effect of visiting nursing of the visiting nursing services based on the district management system on the subjects of stroke patients. Method: A nonequivalent control group pretest-posttest design was applied to 50 stroke patients (31 from the experimental group, 19 from the control group). To evaluate the effects of visiting nursing services. health status(SF-36) and activity daily living(ADL/IADL) were measured from June 2003 to November 2004. Result: Health condition and the activities of daily living (ADL/IADL) of the subjects who received visiting nursing service were shown to be improved. Conclusion: Visiting health service model based on the district management system in public health center is considered to be an effective measure of visiting nursing services in large cities.

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도시와 농촌지역 노인의 건강증진행위와 지각된 건강상태 비교 (The Comparative Study on the Health Promotion Life Style and Perceived Health Status of Elderly in Urban and Rural Area)

  • 박정숙
    • 농촌의학ㆍ지역보건
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    • 제27권2호
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    • pp.137-148
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    • 2002
  • Objectives: This study was to investigate the needs for developing the health promotion program for elderly and to compare the health promoting lifestyles behaviors and perceived health status of elderly in urban and rural area. Methods: The data was collected from 82 elders in urban(D city) and 77 elders in rural area(C county) by face to face interview. The Health Promoting Lifestyle ProfileII(HPLPII) and Perceived Health Status were used. Results: 1) The total score of HPLP was 2.44. In the subscales, the highest degree of performance was 'nutrition', following 'interpersonal relationship', 'stress management', 'health responsibility' and 'spiritual growth' and the lowest degree of performance was 'physical activity'. 2) Elderly people living in urban area had significantly higher the total HPLP score than elderly people living in rural area The urban elderly had significantly higher the score of HPLP subscales such as 'physical activity', 'interpersonal relationship' and stress management than rural elderly. 3) The mean score of perceived health status was 8.79. There was no significant difference in the perceived health status between urban and rural elderly. Conclusions: The above findings indicate that it is necessary to develop a health promotion program with reinforced physical activity, health responsibility and spiritual growth for elderly people in Korea. Especially the physical activity need to he strengthened for rural elderly.

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건강정보이해능력·정신건강정보이해능력 국내연구경향분석 : 2007년-2017년 (Research Trend Analysis of Health and Mental Health Literacy in Korea : 2007-2017)

  • 백정원;이희윤;남희은
    • 보건의료산업학회지
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    • 제12권3호
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    • pp.95-106
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    • 2018
  • Objectives: The purpose of this study was to analyze the recent research trends in health and mental health literacy and suggest their implications for future research. Methods: Ninety six articles on the topics of health literacy and mental health literacy that were published in journals in Korea during the last 10 years analyzed. Results: The majority of articles were published in medical journals, whereas the articles published in social and natural sciences journals were conducted by multidisciplinary research teams and seemed to be increasing generally. The participants studied in the selected articles were mostly older adults followed by adults aged 18 and over, and other various groups including health professionals and immigrant groups. More than 97% of the articles used quantitative research methods. Conclusions: Health literacy mirrors other health inequalities. To increase the level of understanding of health information, studies should be conducted using various variables. It is also necessary to develop a community education program that can be implemented in the community. Futher, the results highlighted the importance of interdisciplinary research. It is hoped that this effort will help solve t health inequality.

Intervention Mapping을 적용한 지역사회기반의 골관절염 자기관리지지 프로그램 개발 (Using Intervention Mapping to Develop a Community-based Disease Self-management Support Program for Patients with Osteoarthritis)

  • 안양희
    • 근관절건강학회지
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    • 제22권3호
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    • pp.245-257
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    • 2015
  • Purpose: The purpose of this study was to apply intervention mapping (IM) to develop a community-based disease self-management support program for patients with osteoarthritis. Methods: IM was applied as follows: i) a needs assessment has been carried out by a literature review, survey and interview with osteoarthritis patients; ii) on the basis of the needs assessment, identification of expected outcomes and change objectives for the target population; iii) selection of theory-based methods and practical applications to influence self-management and the determinants of behavior; iv) design of the intervention by developing activities and materials such as osteoarthritis self-management guide and smart patient pocket book. The activities were integrated into an existing healthcare activities; v) implementation and evaluation plan has been developed. Results: The program is aimed at improving health status through activating patients by a patient-centered and tailored intervention for patients with osteoarthritis; consists of 8 sessions with coaching and cognitive emotional psychological skills; includes smart patient, communication, osteoarthritis, medication adherence, pain control, depressive mood control, physical activity and healthy diet. Conclusion: The IM is a systematic and feasible method for developing the program. The next step is to evaluate the impact of the intervention on activation, and health status.

성인 비만여성들의 체중감량프로그램의 완수도와 관련된 생태학적 요인 분석 (The Ecological Factors Related to Completion of Weight Reduction Program in the Obese Premenopausal Women)

  • 김상연
    • 대한지역사회영양학회지
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    • 제9권6호
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    • pp.683-694
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    • 2004
  • The objective of this study is to improve the health related quality of life through the efficient weight reduction by analyzing the ecological factors related to completion of weight reduction program in the obese premenopausal women aged 20-29 years. The factors influencing completion of obesity management programs in the obese women were the preferences of sweet and salt taste, health related quality of life (general health, role emotional), eating attitude scores, and regularity of mealtime scores. The finding that the completion of obese management programme were improved if the health-related quality of life was high and the physiological status related symptoms of stress, depress, and eating disorder were good has implications for the treatment of obesity. The questionnaire used this study can be available to develop the obesity assessment sheets which is required the exploration of the characteristics of obese women and the tailored multi-disciplinary obesity management program. Moreover, the obesity assessment sheets will make a contribution to determine types of the programs that is suitable for obesity women before starting an obesity management program.

미국 만성질환자가관리프로그램(CDSMP)의 성공 사례와 국내 적용가능성 (The Applicability of the United States' Chronic Disease Self-Management Program (CDSMP) to Korean Adults)

  • 안상남;김건엽;;나윤주;김기수
    • 보건교육건강증진학회지
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    • 제31권4호
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    • pp.63-72
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    • 2014
  • Objectives: The current study reviews the implementation and evaluation of the Chronic Disease Self-Management Program (CDSMP) in the United States (U.S.) to illustrate the program's potential contribution to improving health among Korean adults with chronic conditions while saving healthcare costs. Methods: This study examines existing literature on the history, theoretical background, essential elements, and delivery outcomes of CDSMP with special focus on the successes and challenges to be faced in the implementation of CDSMP to Koreans with chronic conditions. Results: CDSMP is designed to empower people with chronic conditions to develop skills necessary for medical, social role, and emotional management of chronic conditions. Recent studies show the utility of CDSMP in achieving the Triple Aim health reform goals (i.e., better care, better health, better value). Lessons learned from the U.S. experience emphasize the importance of establishing evidence-based studies, collaborating with community partners, and diversifying funding sources to make CDSMP more sustainable. Conclusion: The current study demonstrates the replicability of CDSMP and potential for expansion in Korea. More concerted efforts among academia, government, and communities are needed to deliver CDSMP to Korean adults and identify its effectiveness within the Korean context in terms of meeting the Triple Aim goals of better care, better health, and better value.

노인대상 보건소 방문건강관리사업 간호사의 역할과 직무 (Role and Task of Nurses in the Visiting Health Services at the Public Health Center: Focusing on the Elderly)

  • 한영란;박언아;방미란;안나원
    • 한국보건간호학회지
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    • 제35권3호
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    • pp.430-447
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    • 2021
  • Purpose: The purpose of this study was to analyze the role and tasks of nurses who were working for the elderly in the visiting health services at the public health centers. Methods: Literature reviews, two rounds of meetings with 5 experts and a two-round Delphi technique with 15 experts were performed in this study. Results: The nurses' role and job analysis revealed 5 roles, 16 duties and, 71 tasks. The nurses' roles, including discovery and registration of households/groups in visiting health service in the community, case manager, administrative management, program planning, operation and evaluation, and development of job competency. Sixteen duties included client registration and management, need assessment and plan establishment, education, consultation and support, seasonal health care, prevention and monitoring of infectious diseases, basic nursing care, chronic disease management, linkage and utilization of resources, team cooperation and coordination, home environment management, monitoring and support for intervention outcomes, evaluation, administrative management, program planning, operation and evaluation, development of professional competency and, adoption of fourth industrial revolution technology. Conclusions: Based on the results, the government should provide sufficient nursing personnel to provide universal preventive health services for the elderly and a job training program to perform these roles well.

고혈압 진단자의 혈압 관리를 위한 외래 방문 영향요인 (Factors Related to the Outpatient Visits for Blood Pressure Management in Patients diagnosed with Hypertension)

  • 조형경;이현지;설진주;이광수
    • 한국병원경영학회지
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    • 제26권2호
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    • pp.56-67
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    • 2021
  • Background: Regular doctor visits are vital for hypertension patients, especially for who have never received hypertension medication or non-pharmacologic therapy. This study purposed to study factors affecting outpatient visits for patients diagnosed with hypertension. Methods: This study included 59,009 respondents with hypertension over 30 from 2019 Community Health Survey data. Outpatient visits were defined by having hypertension treatments such as medication or non-pharmacologic therapy. Logistic regression was used to examine the factors affecting outpatient visits using SAS ver. 9.3. Results: 57,081(96.73%) patients with hypertension were identified as those having a outpatient visit for hypertension treatments, whereas 1,928(3.27%) patients did not have visits. Patient's characteristics such as gender, age, periods of hypertension, education level, perception of the blood pressure, hypertension management education, place of living, body mass index, depression and diabetes were found to have statistically significant relationship with the outpatient visits. Practical Implications: There is a need to select patients with high blood pressure who are unlikely to visit for hypertension treatments based on the study results. For those, establishing a personalized management plan such as health education and counseling programs will be helpful for the successful implementation of national chronic disease management program.