• Title/Summary/Keyword: Community-based Medical Service

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Needs Assessment of Elderly for Community-based Long-Term Care (요양보호 대상노인의 서비스 요구도 평가)

  • Lee, Jae-Chang;Kim, Eun-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.1
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    • pp.67-77
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    • 2005
  • Purpose: Needs of health-welfare-medical service for the elderly is rapidly increasing in Korea. The purpose of this study was to evaluate the needs of health-welfare-medical service for the long-term care elderly in the community and to compare differences by their characteristics. Method: Needs assessment was completed in the homes of 598 persons over 65 years by using the tool of needs assessment, between November and December, 2003. We examined all the health-welfare-medical service of elderly in the community. Data were analyzed using SAS program. Result: The needs of the long-term care elderly in community was largest 'home visiting service of visiting nurse(87.5%)', and then 'religious, psychological and emotional support(73.9%)', 'home visiting therapy of physician(58.5%)', 'social support service(55.7%)', 'health improvement program of public health center and social welfare center(51.8%)', 'health examination(48.8%)' followed. The difference of health-welfare-medical service needs among characteristics(age, medical security, caregiver existence, and regions) was statistically significant by service contents(p<0.05 or p<0.01). Conclusion: We can apply it in the distribution of community resource and the development of service providing programs by figure out the needs assessment for the long-term care elderly in the community, and consequently, through this, realizing the health maintenance and promotion of the long-term care elderly.

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A Research on the improvement measures about Community-based Korean medical public health service in public service center (보건소 한방지역보건사업의 개선방안에 대한 연구)

  • Choi, Kwang-Jin;Kim, Hong-Jun;Ahn, Sang-Woo
    • Korean Journal of Oriental Medicine
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    • v.10 no.1
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    • pp.107-117
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    • 2004
  • Each Local public heal public health service center is in difficult situation on programing and performing of local public health service. The purpose of research is to inquire of the present state of local public health service and search long-term developmental methods. The first, in order to accomplish this purpose, I distributed questionnaires to Korean medical doctors, who are worked in public health service center and researched that. The second, based on these findings, I proposed planning for upcoming project for activating local public health service on Korean medicine.

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Evaluation of a Community-Based Rehabilitation Program in Wonju City (원주시 지역사회중심 재활사업 평가)

  • Yi, Chung-Hwi;Lee, Hyun-Ju
    • Physical Therapy Korea
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    • v.10 no.1
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    • pp.139-158
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    • 2003
  • This study evaluated the community-based rehabilitation services provided by the Wonju Public Health Center from Jan. 2000 to Dec. 2002. Ninety-four persons with disabilities dwelling in the community participated and the surveys were completed in an interview during home visits. The respondents' demographic, socio-economic, and medical characteristics, rehabilitation service received, willingness to receive home-visit rehabilitation services, and satisfaction with the rehabilitation services were analyzed by frequency and percentage. A Likert scoring system consisting of five agreement-disagreement categories was applied to each item, consisting of Very Satisfied, Satisfied, So-So, Poorly Satisfied, and Very Poorly Satisfied. The major findings were as follows: 1) The rehabilitation services used included medical rehabilitation (26.9%), followed by social assistance (23.5%), diagnosis by a physician at home (17.3%), medical examination (12.3%), housekeeping services (6.2%), and vocational and educational rehabilitation (3.5%). 2) Of the medical services, the respondents desired physical therapy at home and free rental of rehabilitation equipment, such as wheelchairs, canes, walkers, the most, followed by home visit occupational therapy, nursing services, and oriental medicine service in descending order. 3) Some of the respondents expressed so-so satisfaction (50.0%) or dissatisfaction (16.9%) with the rehabilitation services provided by the Wonju Public Health Center. These findings should prove useful when planning or extending community-based rehabilitation programs for the homebound disabled in the community.

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Effectiveness of Community-based Case Management for Patients with Hypertension

  • Yun, Soon-Nyoung;Lee, In-Sook;Kim, Jin Hyun;Ko, Young
    • Research in Community and Public Health Nursing
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    • v.25 no.3
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    • pp.159-169
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    • 2014
  • Purpose: The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization. Methods: This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA. Results: All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group. Conclusion: This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.

The Relationship between Family Burden and Mental Health Service Needs of Family for Home-based Chronic Mental Patients in Community (지역사회 재가 만성정신질환자 가족의 부담감과 정신보건서비스요구와의 관련성)

  • Kim, In-Hong
    • Journal of agricultural medicine and community health
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    • v.33 no.3
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    • pp.269-278
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    • 2008
  • = ABSTRACT = Objectives: This study was carried out to identify the relationships of family burden and mental health service needs of chronic mental patients in community. Methods: Objects of the study were 153 chronic mental patients in community of P. city in korea. Data were collected from December, 2007 to February, 2008 using structured questionnaire. Research tools of this study were family burden tool developed by Pai & Kapur (1981) and mental health service needs tool developed by Kim (2003). Results: The average grades for family burden was 1.62 points. And the biggest part of family burden was economic burden(1.74), followed by interrupt of daily life(1.67), interrupt of family relationship(1.64), interrupt of family leisure (1.57), effects of mental health(1.50), and effects of physical health(1.43). The average grades for mental health service needs was 2.72 points. And the biggest part of mental health service needs was rehabilitation service(3.09), followed by social service(2.87), and Psychiatric medical service(2.21). Positive correlation showed between all parts of family burden. And, positive correlation showed between psychiatric medical service and interrupt of daily life(r=.281, p<.01), psychiatric medical service and effects of physical health(r=.355,p<.01), social service and effects of mental health(r=.213,p<.01). Conclusion: The family burden for care giver of mental patients was related with all parts of family burden and mental health service needs of family. Thus, these results should be considered to reduce family burden for care giver of mental patients in community.

A Need Analysis for Medical Supporting Service as a Part of Community-based Hospice Palliative Care (지역사회기반 호스피스완화케어에서의 의료지원서비스 요구분석)

  • Kwon, So-Hi;Kim, Sook-Nam;Choi, Soon-Ock;Kim, Jung-Rim;Ryu, Ji-Seon;Baik, Jeong-Won
    • The Korean Journal of Health Service Management
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    • v.10 no.4
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    • pp.109-121
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    • 2016
  • Objectives : This study was conducted to investigate the need of medical supporting service (MSS) as a part of community-based hospice palliative care from the view point of beneficiaries and providers. Methods : This study adopted a methodological triangulation design. A questionnaire regarding intention to use MSS was completed by 175 patients under home-based cancer patient management program. And three focus groups consisted of hospice nurses, public health physicians, and public officials were interviewed to obtain the perceived needs, obstacles, and solutions of MSS. Results : Mean age of home-based cancer patient was 70.18 year old, 48.0% of them were living alone. Only 53.7% of them were treated pain and 93.7% intend to take pain medication prescribed by public health physician. All participants of focus group interviews agreed necessity and importance of MSS. Physicians' lack of confidence and unwillingness to prescribe opioid to terminal patients was the biggest obstacle to provide MSS in the public health center. Conclusions : The necessity and demand of MSS for community-dwelling cancer patients were verified. MSS is urgent issue to meet their needs.

Comparative Research of the Medical Cost, The Quality of Life, The Family burden of the Mentally III before and after the Community Mental Health Service (지역사회 정신보건서비스 제공 전$\cdot$후 정신장애인의 의료비용, 삶의 질, 가족 부담감 비교연구)

  • Noh In Young
    • Journal of Korean Public Health Nursing
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    • v.15 no.1
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    • pp.56-72
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    • 2001
  • Community mental health management system emphasizing on the rehabilitation and the return to the community has been established and carried out for many years. The study has been demanded to prove that the decreasing rate of the recurrence of the mentally ill resulted to lower their medical costs, to enrich the quality of life, and to reduce the psychological burden of their family. This study tried to prove that the mental health services to the mentally ill which were registered in community mental health center of A city have an influence on the medical cost, the quality of their lives. the family burden. The subject group of this study were 39 home-based mentally ill patients and their 37 family members, totally 76 people registered in mental health center of A city and participated in its program. This research had been measured twice, the first before the intervention and the second after at least a year. The measuring tools in the research were the medical cost measurment tools developed by the researcher, the quality of life index by Yoo ja, Noh(1988) and the family burden by Montgonery(1985). The methods were modified and supplemented in this study. This research made use of SPSS Win 10.0. The results of this study are the same as followings. 1) There were the significant difference in the medical cost before and after the mental health service delivery. 2) The quality of lives of the mentally ill, after the mental health services delivered were significantly higher than before. 3) The family burden were significantly reduced after the delivery of community mental health services. Community mental health services brought out efficient results to the social return and rehabilitation. And these results means that the mentally ill changed highly the quality of life and their burden of family and medical cost were reduced. So the public organization and the private society should help positively the mentally ill and their family through mental health policy and social service agency to live healthy lives and to be valuable member of society.

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Accessibility of Community Pharmacy-Based Pharmaceutical Care Service in Korea (우리나라 지역약국 약료서비스의 접근성 현황)

  • Song, Jong Kyung;Yoo, Bong Kyu
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.282-287
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    • 2014
  • Objective: Objective of this study was to investigate community pharmacy-based pharmaceutical care accessibility in Korea. Survey on the current pharmaceutical care service provision was performed by PM2000 XE, a real-time pharmacy manager program, operated by Korea Pharmaceutical Information Center beginning November 4, 2013 until December 6, 2013 towards all community pharmacies throughout the nation which use the program. Method: The survey questionnaire consisted of four sections: pharmacy type, time-based accessibility, item-based accessibility, and spatial accessibility for non-prescription drugs. Results: Number of pharmacy responded to the survey was 331, and size of the responding pharmacy was mostly medium-scale (66.47%) with 30-99 prescription fillings a day. Proportion of pharmacy with opening hour of 12 hours or longer was only 53.77% and it was less than 25% during saturdays and holidays. Item-based accessibility was generally acceptable for prescription and non-prescription drugs, medical devices, and health supplements. However, spatial accessibility for non-prescription drugs was problematic because only one quarter of the drugs was displayed over the counter, and most of the drugs were behind the counter so that customers could not reach out. Conclusion: Based on the survey result, current situation for accessibility of pharmaceutical care service in Korea is concluded inadequate and therefore needs multidimensional efforts to improve accessibility of the service at national level such as Korea Pharmaceutical Association and Ministry of Health and Welfare.

A Study on the Support System of the Elderly in Japan for the Realization of Aging in Place (에이징 인 플레이스 실현을 위한 일본의 고령자 지원체계 연구 - 지역포괄케어시스템의 구축을 중심으로 -)

  • Yoon, Hye-Yeong
    • Journal of the Korean housing association
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    • v.25 no.2
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    • pp.99-107
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    • 2014
  • This study attempts to provide implications for developing more efficient and effective community-based support system with AIP perspective for the elderly in Korea. The main purpose of this study is to analyze Japan's community-based integrated care system that respond to the concept of aging in place (AIP) and its cases. In Japan, they have offered Community-Based Service since 2005, and the advanced system which include integrated support categories and consolidated community/local resources will started in 2015 by The revision of Long-term Care Insurance policy, 2012. The result of policy analysis and case studies are as follows: 1) The suggestion for ideal support system model promoted a relationship of multiple agents include private sectors even resident and senior and specified responsibility sharing, 2) the system proposed Not only health and medical care support, living care and residence are also addressed as a comprehensive support. and 3) the amount of available community resource is different by each local government, but the effort to get the understanding of community residents and to connect with a potential community resource is also essential aspect to set effective community-based support system.

A Preliminary Study for Evaluating on Demonstration Project of Community-based Home Health Care Nursing Services by the Seoul Nurses Association (지역사회중심 가정간호 시범사업 성과평가를 위한 기초연구- 서울시 간호사회 주관 -)

  • 유호신;이소우;문희자;황나미;박성애;박정숙;최행지;정기순;한상애
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1488-1502
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    • 2000
  • This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

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