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

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Occupational Therapy for Community Mobility in Stroke Patients : Systematic review (뇌졸중 환자의 지역사회이동을 위한 작업치료 중재: 체계적 고찰)

  • Jo, Eun-Ju;Kam, Kyung-Yoon;Chang, Moon-Young
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.3
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    • pp.77-89
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    • 2018
  • Objective : The purpose of this study was to analyze occupational therapy intervention on the community mobility for stroke patients, and to provide evidence of intervention in the clinical fields. Methods : A systematic review was executed according to the PRISMA checklist. The accessed database was PubMed, EMBASE, Cochrane Library (CENTRAL), ProQuest Dissertations & thesis (PQDT), RISS, and KoreaMed. We included the articles published from 2005 to September 2018. RoBANS checklist was used to evaluate the quality of the articles. Included articles, totally eight, were categorized according to the type of intervention. Results : The study design of the literature was varied from two-group randomized trial, quasi-experimental study, case-control trial, one group pre-post comparison study, and cross-sectional study. In the evidence level, 6 articles were included in level II (75%). The percentage of low risk of bias in each article ranged from 52.5%~87.5%. Four studies (50%) provided intervention based on virtual reality or virtual environment. The three (37.5%) provided intervention based on the protocol, and the other (12.5%) did wheelchair training. All studies reported significant effects of the intervention. Conclusion : This systematic review provided evidences to use proper intervention in the clinical fields. Various type of studies should be conducted to prove the effect of occupational therapy intervention for community mobility.

A Study on the Design of the Knowledge Management System for Medical Information Services in a Public Library (공공도서관 의학정보서비스를 위한 지식관리시스템 설계에 관한 연구)

  • 이란주
    • Journal of the Korean Society for information Management
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    • v.18 no.3
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    • pp.63-86
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    • 2001
  • Consumer health information is receiving more attention than ever before. This growing attention can be linked to the Internet and to people seeking more information on health topics. The purpose of this study is to suggest a design of the Knowledge management system for medical information services in a public library. As theoretical backgrounds, it discusses the issues regarding to the medical information services in a public library, knowledge management and knowledge management system. After that, 12 medical information sites are analyzed then the planning and the main menu of a medical information site for a public library are described. Finally, the model of the knowledge management system for a public library with 5 sub-systems are suggested: 1) knowledge creation system, 2) technology support system, 3) training system, 4) community service system, 5) knowledge sharing and network system. This system based on knowledge management will help provide the users high quality of medical information.

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

  • Lim, Eunok;Kim, Hongsoo
    • Health Policy and Management
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    • v.27 no.2
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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.

Utilization of Medical Assistance Patients in Nursing Hospital (의료급여환자의 요양병원 이용에 관한 연구)

  • Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.17 no.5
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    • pp.366-375
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    • 2017
  • The purpose of this study is to analyze the use of hospital, hospitalization, medical service, discharge and power of medical care patients who are concerned about moral hazard. We conducted focus group interview with 3 medical care patients and their families and 5 workers who had worked for more than 4 years in a nursing hospital. The main results and implications are as follows. First, admission to nursing hospitals was mostly based on the linkage between the medical institutions and the competition to attract the patients rather than the choice of the patients. Second, the main cause of the long-term hospitalization of medical assistance patients was the lack of social protection measures such as absences of residence and care giver, although there are factors that cause moral hazard such as low self-pay. Third, most of the patients were in need of treatment, but they were admitted to the hospital even though their needs were not higher than those of the health insurance patients. Fourth, the rehabilitation service is the mainstay of the medical service of the nursing hospital, and the roles of nursing staff and care givers are important. Fifth, medical care patients are paying medical expenses for nursing hospitals due to cost of living and family support, but they are exempted from the hospital expenses or the burden of their own expenses in the hospital. Sixth, public institutions and social welfare institutions have not managed continuously since commissioning patients to nursing hospitals and have neglected the connection with community services after discharge.

Development of Community Health Center-Based Hospice Management Model: Pilot Project at a Community Health Center in Busan (보건소 중심 호스피스 운영모델 개발 - 부산지역 일개 보건소 시범사업을 중심으로 -)

  • Kim, Sook-Nam;Choi, Soon-Ock;Kim, Young-Jae;Lee, So-Ra
    • Journal of Hospice and Palliative Care
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    • v.13 no.2
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    • pp.109-119
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    • 2010
  • Purpose: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. Methods: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. Results: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. Conclusion: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.

The Need and Perception about Volunteer of Student from Department of Health Care for the Old in the Community : Focus on Ulsan City (보건계열 대학생의 봉사활동에 대한 지역사회 노인의 욕구 및 인식차이 조사 : 울산광역시 중심으로)

  • Hong, Eun-Kyoung;Kim, Kyeong-Mi
    • The Journal of Korean society of community based occupational therapy
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    • v.2 no.2
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    • pp.71-80
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    • 2012
  • Objective : The objective of this research tried to know the differences about the perception of volunteering between the elderly group of seniors with experience of college's Department of Health Care Services and the elderly group of seniors without it. Method : We researched 79 people aged using the facilities for the elderly and the facilities for welfare for the aged from August 2010 to November 2010. Result : As a result of perception of the old according to whether to experience in services of students in the college of department of health care or not, the old (89%) of the whole person was positive. The perception of the volunteer of student in the department of health care was not a statistical difference between the old group with experience in volunteer service and the old group without it. The field that two groups want to be serviced was the highest in the department of rehabilitation. Conclusion : It is necessary for the university with the functions of social service to provide health and medical service to the old in the community through systematic training to meet their needs.

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Evaluation Study of Home Health Care Program Operated in G Public Health Center (인천광역시 일 보건소 대도시 방문보건사업의 평가 연구)

  • Kim, Myung-Soon;Kim, Young-Sook
    • Research in Community and Public Health Nursing
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    • v.15 no.4
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    • pp.539-550
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    • 2004
  • Purpose: The purpose of this study was to evaluate the achievements of the project, and also to find out its strengths and weaknesses. Method: This evaluative study employed system theory and analytic techniques by using criteria which were relevance, appropriateness, adequacy, progress, effectiveness and satisfaction for input, process, output, and outcome of program. Study subjects were participants in the home health care program implemented in G public health center in Inchon metropolitan city in 2003. Results: Input factors including recruitment personnel, and support organization development were not adequately met for the program. However. the goal and objectives of the project were really appropriate for the community needs as well as government's policy. For the Process evaluation, home health care record form and computer data base had not progressed as scheduled, but overall program activities were finished on time. However, cooperation between organizations in the health center during service activity were not supportive. Managerial ability of program charged personnel about coordination and integration of team members was not affirmative. Output and outcome evaluation showed that people improved self care ability were 221 (17.5%). and 71 (5.62%) of subjects were moved into category of possible self-care. Client's satisfaction for this project showed a high degree. Conclusions: Based on the above results support organization and staff personnel for this program should be developed. Also, a community network of resources should be established and case management services should be focused continuously in community based home health care.

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A Basie Community Health Survey in Rural Korea (Soyang-Myun) (소양면 지역사회 환경기초조사)

  • Choi, Sung-Yul
    • Journal of Preventive Medicine and Public Health
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    • v.6 no.1
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    • pp.133-160
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    • 1973
  • 1. Introduction Community medicine with the concept of comprehensive medical care and an ideal medical care delivery system not only for an individual or family but for the whole community has emerged. In April 1970, the Presbyterian Medical Center started a hospital based community health service project in order to improve the health of the people in rural areas. Prior to commencing a comprehensive medical care system, a family survey was needed. The major objective of this survey was to obtain information concerning the people and their environment so as to be able to plan and implement a comprehensive medical care program in Soyang-Myun. 2. Survey Method An interview using a family record form was carried out for each household. This family record form was designed to get information about demography, family planning, environmental sanitation and vital statistics. Prior to beginning, the members of the survey team were trained in interviewing techniques for three days. The team consisted of a public health nurse, four nurse-aides, a sanitarian and four health extension workers who are working in our project, The survey was carried out during the period November 1971 to March 1972. 3. Project area 1) Population of Soyang-Myun was 11,668; male, 5,962 and female, 5,706. Sex ratio: 104.5. 2) Households : 1,858 3) Family size: The average household consisted of 6.3 persons. 4) Educational level of householder a. Illiterate 13% b. No schooling but able to read 10% c. Preschool children 19% d. Primary school 47% e. Middle school 7% f. High school 3% g. College or University 1% 5) Occupational distribution of householders a. Farmer 67% b. Laborer 13% c. Office worker 4% d. Merchant 4% e. Industrial worker 2% f. Unemployed 8% g. Miscellaneous 2% 6) Religious affiliation a. No religion 74% b. Buddhist 12% c. Protestant 10% d. Catholic 4% 4. Survey results Living Environment : a. Home ownership 95% b. Kinds of roofing Straw-thatched house 84% Tile-roofed house 10% Slate-roofed house 5% Other 1% c. Floor space Less than 6 pyong 10% 6-10 pyong 53% 11-15 pyong 24% 16-20 pyong 9% More than 20 pyong 4% d. Radio ownership 80% Environmental Sanitation : a. the source of drinking water public well 49% private well 30% drainage water 9% steam water 8% well pump 3% water distribution system 1% b. Distance between well and toilet more than 16meters 38% 6-10 meter 31% 11-15 meters 14% Less than 6 meters 17% c. The status of well management Bad 72% Fair 26% Good 2% d. General sanitary state of house Bad 37% Fair 51% Good 12% e. House drainage system had no house drainage. 77% Family Planning : a. 24% of the people have used contraceptives, but 12% ceased to use them. 76% have never used contraceptives. b. used methods 1oop 68% oral pill 16% vasectomy 4% condom 1% tubal ligation 1% two or more methods 10% Maternal Health : a. The number of conceptions of housewives under 50 years of age. 11 times 26% 6 times 11% 5 times 11% 4 times 9% b. The place of delivery own house 88% hospital 1% others 11% Treatment of general sickness : a. The place of treatment Soyang Health Center 31% Hospital (private or otherwise) 26% Pharmacy 14% Herb medicine 5% Private care 5% No treatment 12% Miscellaneous 7% b. Usual causes of diseases Unknown 46% Tuberculosis 29% Neuralgia 8% CVA 3% Bronchitis 3% Others 11%

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노인복지시설의 호스피스 운영모형 개발

  • Yun, Eun-Gyeong
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.1-20
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    • 2002
  • The purpose of this study is to develop a management model to effectively provide hospice service of nursing home. In a method of study to achieve this purpose, a positive research and literature study have been performed at the same time. Concerning contents to be examined as a definition of notions and patterns about hospice for the aged, foreign hospice and structural elements of hospice management, a literature study to support a theoretical background has presented leading studies as an analysis form of this study through analyzing domestic and foreign literature, thesis, journal and so on. In order to attain the purpose of this study, the positive research is to carry out a survey of demand and desire of people who have already got hospice service in the first place as a fact-finding survey related to the subject of hospice service, investigate organizations to operate nursing home and hospice and relevant experts in the second place as a survey of supply system to provide hospice service, and develop an appropriate management model to connect the demand and supply of nursing home through it. Therefore, this study has developed a delivery system and a chart of the practical trend to be done minutely, presenting a model to manage a hospice of nursing home based on the above results. The management model externally has connected medical team of hospital with hospice team of home based on a community, and internally is composed centering on five elements such as administrative organization, manpower, program and contents of service, finances. In practical model of hospice management of nursing home, in order to plan a program, provide service and give a high-quality service to the aged, this study has presented a trend chart of service management on the basis of five structural elements, an analysis form of this study. In conclusion, this study could present data to develop a hospice in the field of nursing home for the aged by showing a model concerning a hospice management of nursing home, but in my opinion, a following study to be detailed and developed even more than this study should be continued.

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Proportions of non-matching fund by local governments and central government subsidies in local government health budget: focused on 2020 Jeju Self-Governing Province Budget (지방자치단체 보건의료 사무의 세출예산 구성과 자체재원 비율 - 제주특별자치도 사례를 중심으로)

  • Yoo, Hyeyoung;Jeong, Ji Woon;Park, Hyeung-Keun
    • Journal of agricultural medicine and community health
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    • v.46 no.4
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    • pp.266-279
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    • 2021
  • Objectives: The purpose of the study was to classify the health and medical service affairs of local governments, and to analyze the proportions of non-matching fund by local governments and central government subsidies for local government health budget. Methods: First of all, health affairs of local governments were classified to categories based on health-related laws and previous studies by review of the authors. In order to specify the scale of local government-led health affairs, we allocated 1,916 budget units into 6 main and 24 sub categories of the health and medical service affairs of local governments for the 2020 health budget of Jeju Special Self-Governing Province. For each categories, we compared the total amounts and the percentages of the 'central government subsidies', 'local government budget - matching fund', and 'local government budget - non-matching fund'. Results: The total health budget of Jeju Special Self-Governing Province accounts for 1.2% of the total budget. Of the total health budget of Jeju Special Self-Governing Province, the proportion of central government subsidies was 39.6% and the proportions of local government budget-matching fund and non-matching fund were 33.8% and 26.6%, respectively. The proportions of non-matching fund by provincial and basic local governments were 37.3% and 19.9%, respectively. Conclusion: In order for local governments to deal with the health problems of residents, it is necessary to secure and spend more local government budget(i.e., non-matching fund by local government) for health affairs in their administrative jurisdiction.