• Title/Summary/Keyword: Elderly Health Policy

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The meaning and challenges of the introduction of the Customized Care Services for Older Adults (노인맞춤돌봄서비스의 도입 의미와 과제)

  • Chon, Yongho
    • 한국노년학
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    • v.40 no.4
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    • pp.599-616
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    • 2020
  • The South Korean government has introduced a new Customized Care Service for Older Adults by eliminating the six existing care services for them since 2020. It is a significant change of care service system for older adults and the service would play a key role in providing preventive services for them. The aim of the study is to examine the meaning and tasks of the introduction of the Customized Care Services for Older Adults in South Korea by using the framework of Gilbert and Terrell. The study found that the new service was designed under the government's policy contexts of the establishments of public-based social service providers and the emphasis of community care, and it has brought about a number of significant institutional changes of care system in terms of allocation, benefits, delivery, and finance. The institutional coverage of the service was increased to lower 70% of older adults and a large number of kinds of health and social care services would be provided for them. The sphere of living was set in each local area and the new service providers are entirely in charge of providing the services in each sphere. The financing system was changed to support service providers by providing government subsidies. Although a number of positive results would be expected to occur for the elderly, it is likely that some challenging tasks would happen in the fields as follows: the inadequate coverage, the vagueness of the application of self-care principle and the decrease in the amounts of direct care services, the inappropriate area of service provision, and the supplier-oriented provision of services rather than user-oriented.

The study on the entry of dental technicians in the public health center for a manpower supply and demand plane (Centering around a denture insurance policy in 2012) (인력수급 대책을 위한 치과기공사의 보건지소 진출에 관한 연구 - 2012년 틀니보험화 정책을 중심으로 -)

  • Lee, Jong-Do;Kim, Jeong-Sook;Park, Kwang-Sig
    • Journal of Technologic Dentistry
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    • v.32 no.4
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    • pp.417-433
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    • 2010
  • Purpose: This study evaluated the manpower planning of dental technicians. Methods: Methods : Survey was conducted regarding subject's general characteristics, characteristics of dental technician's occupational view and working conditions, and reason to enter into branches of the public health enter. The survey sample consisted of 323 dental technicians (221 male/ 102 female). Survey was conducted for one month from August 1 to September 1 in 2010. Following results were obtained. Results: 1. Regarding general characteristics of the subjects, there was a slight male predilection with 68.4%. Subjects in their 40s occupied the highest proportion of 32.2%. Majority of subjects worked in the big cities (71.5%). Favored working places were dental laboratory (57.6%) and dental hospital or dental clinic (19.5%). Although no position is available in the public sector such as public health center or health care civil servant, 9.3% preferred working in the public health center. Public sector is more favored than 2-year technical colleges or dental supply and equipment companies. In respect to education, 57% of the subjects graduated college. 67.8% were married. Subjects who specialize in the porcelain or all-ceramic were 57.9%. With regard to current position, head of the dental laboratory was most common. 2. Following occupation characteristics were found. Economic reason took the highest proportion when deciding their occupation (39.9%) followed by gaining social experience (36.5%). Majority of the subjects (76.5%) wanted to work as dental technicians until their retirement. 71.5% pursuit to become a manager of the dental laboratory. 76.1% agreed on opening a dental technician position in the public health center. Regarding an authority to lead developing the dental technician position in the public sector, majority of the subject chose ministry of health and welfare (35.6%) and Korean dental technologist association (34.7%). Employment (average, 30%) and turnover rate (average, 36.5%) of dental technology college graduates ranged from 40% to 60%. Most important factors for the employment were practical experience (41.2%) and competency (34.4%). With regard to job satisfaction, so-so as 46.7% and satisfactory was 42.7% 3. In respect to the reason for opening a position in the public health center, 'It is needed to continue denture rogram for elderly patients' obtained the highest score (4.14 point). 'Institutional devices are required to open a position for dental technicians as a public healthcare provider' received high score (4.11 point). 4. Concerning the working conditions, 'professional knowledge is required' received the highest score (4.23) followed by 'too short maternity and parental leave' (4.21). 5. Relationship between general characteristics of the subjects and favor of working in the public health center was investigated. Significant differences were found according to the current and favored working area, favored occupation, education level, marital status, and specialty. Working in the public health center was favored by following subjects: working in mid- or small-sized cities (4.16 point, p<0.05); PhD degree-holder (4.59 point, p<0.01). 6. Among general characteristics of the subjects, significant difference of working conditions was found in the following factors: gender; working areas; favored working areas; favored working positions, and education level. Majority of subjects favored working in big cities and currently work in big cities although satisfaction was comparatively low (3.75 score). 7. Future plan to work in public health center was evaluated according to occupational characteristics. Subject's intention to work in the public healthcare center was significantly affected by opening of dental technician position, leading authority, average turnover rate, and factors affecting employment. Working in the public health care center was favored by the following subjects: Dental technicians who actively supported opening of the dental technician position (4.34 point, p<0.001); subjects who thought the Korean dental technologist association is responsible for the opening of positions in the public sector (4.26 point, p<0.001); and subjects who thought that attitude and character are important for the employment (p<0.001). 8. Concerning difference of working conditions according to the occupational characteristics, significant difference was demonstrated by factors such as a reason to choose to be a dental technician, work plan, pursuing position, responsible authority, average employment rate, and job satisfaction. High standard of working conditions was required in subjects who selected to be a dental technician for the leisure time after work (s.05 point, p<0.01), who planted to work until their marriage (4.25 point, p<0.001), and who pursuit to be a manager (3.98, p<0.05). 9. In respect to influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.068 and age affected the working condition with significant difference according to the pvalue. 10. Regarding influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.335 and work plan, opening of dental technician position in the public sector, and responsible authority had significant influence over the subject's intention to work in the public health center according to the p-value. 11. With regard to the influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.091 and reason to choose to be a dental technician, work plan, and responsible authority significantly affected subject's working conditions. Conclusion: Korean society is becoming a super-aged society according to several statistics. As aged population is rapidly increasing, national health insurance plans to cover denture for senior citizen over 75 years old from 2012. Therefore, dental technicians are urgently needed in the public health centers all over the nation. Many subjects in this study planed to work until their retirement and recognized dental technician's expertise. Ministry of health and welfare and Korean dental technologist association should co-operate each other to prepare foundation and institutional devices for dental technicians to advance into the public health center. This will improve oral health of the population. This study showed urgency of medical facilities and services which meets increasing number of aged population and welfare of the population.

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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Study about the relationship between Chief complaint of pure death patients using medical record information (의무기록 정보를 활용한 순사망환자 주호소 증상과 진단명과의 연관성에 관한연구)

  • Kim, Yong-Ha;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.13 no.1
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    • pp.407-414
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    • 2015
  • This study was executed to be used as the basic data for the improvement of hospital therapy by analyzing the characteristic of principal diagnosis of pure death patients. 428 pure death patients were selected as study subjects out of 1992 dead patients at K university hospital in Daejeon city for three years in 2011, 2012, 2013, and chi-squared test and fisher's correct tests and canonical correlation analysis were used as analysis methods. In the analysis results about general characteristic and top 4 canonical correlation analysis, pneumonia(J18) of organism unspecified and toxic action(T60) of pesticide showed significant results among the principal diagnosis. In the pneumonia of organism unspecified(J18), significant results were identified with the order of car insurance, ages from 15 to 29, health insurance and medical benefits, and in the toxic action of pesticide(T60), significant results were identified with the order of health insurance, medical benefits, car insurance, ages from 45 to 59, Sejong Chungnam. In conclusion, in order to reduce the death of elderly population, quality improvement in medical service and establishment of emergency medical service delivery system are very important to reduce pure death patients.

A Study on Relationship between the Practice of Aerobic Exercise and the Prevalence and Risk of Arthritis with Comorbid Chronic Diseases (유산소운동의 실천과 만성질환이 동반된 관절염의 유병률 및 위험도에 대한 관계 연구)

  • Yoon, In-Sang;Lee, Hye-Lim;Lee, Jongseok;Jung, Deuk
    • Journal of Digital Convergence
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    • v.19 no.8
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    • pp.351-359
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    • 2021
  • This study was conducted to analyze the relationship between the practice of aerobic exercise and the prevalence and risk of arthritis with comorbid chronic diseases. For this study, the National Health and Nutrition Examination Survey 2017-2019 data were used and 17,356 people were selected as subjects. The relationship between the practice of aerobic exercise and the prevalence and risk of arthritis according to demographic characteristics and chronic diseases was analyzed by the chi-square independence test and Breslow-Day test. While the rate of aerobic exercise was low among women, the elderly, the low-income group, the low-education group, and people living in rural areas, the prevalence and risk of arthritis were relatively high. And in the chronic disease-positive group, those who practiced aerobic exercise had a relatively lower prevalence and risk of arthritis than those who did not. In particular, the practice of aerobic exercise was an effective complement in reducing the prevalence and risk of arthritis in people with high blood pressure, diabetes, and dyslipidemia. Therefore, the practice of aerobic exercise such as walking, slow running, and aerobic dance should be recommended in terms of the preventive medicine and health care to people who are in the group with a high prevalence of arthritis in demographic characteristics and people who have comorbid chronic diseases.

Qualitative research of single-person household for a wearable healthcare system providing ischemic heart disease information and a cardiac arrest alarm: Focusing on unmarried workers in their 30s (허혈성 심장질환과 심정지 알람을 제공하는 웨어러블 헬스케어 시스템에 대한 1인 가구원의 질적 연구: 30대 미혼 직장인을 중심으로)

  • Kim, Hyo-Jin;Chae, Ha-Eun;Lee, Joo-Hyeon
    • Journal of Digital Convergence
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    • v.17 no.3
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    • pp.235-251
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    • 2019
  • The purpose of this study was to investigate the single-person household's demand for a wearable healthcare system that provides the ischemic heart disease and cardiopulmonary alarm to be developed. In this study, in-depth interviews were conducted with six unmarried individuals in their thirties who were in the workplace and the results were interpreted by Giorgi's phenomenological analysis method. The study results indicated that although the wearable healthcare system was implemented with high-technology functions that serve the intended purpose, it is necessary to comprehensively consider factors such as aesthetics, comfort, and ease of washing. In this study, we found that the variables influencing the interviewees' intent to accept healthcare services are complex and cannot be attributed to one factor alone; this study has also shown a variety of interpersonal correlations. In addition, although health-care research focusing on the elderly has been conducted in the past, it is suggested that younger generations such as those in their thirties can also be studied as health care service adopters.

Suggestions on Expanding Admission Number of Medical School (의과대학 정원 확대에 대한 제언)

  • Eun-Cheol Park
    • Health Policy and Management
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    • v.34 no.2
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    • pp.120-128
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    • 2024
  • From February to now 2024, there continues to be controversy over the expansion of admission number to medical school. Some of the controversy arises from a mix of present and future time points. In the present time point, the controversy over whether physicians are some shortages or not has various aspects. Some aspects are presented as evidence of the physician shortage and others as non-shortage. Also, the presenting evidence of shortage is being disputed, and so is the evidence of the contrary. This controversy over whether there is a shortage or not in the present time point makes it difficult to reach a consensus. In 10 years, the shortage of doctors will increase due to the rapid increase in the elderly population, so the admission number of medical schools will need to be increased. However, the increase must be such that there is minimal deterioration in the quality of medical education. More admission numbers should be allocated to medical schools with a high quality of medical education. This study suggests that large-scale medical schools increase the admission number by 20%-30%, and small-scale medical schools increase the admission number by 40%-50%, if so, the total increasing number is 760 to 1,066. If the 2,000-person increase is enforced, the quality of medical education must be carefully evaluated and the results should be reflected in adjusting the admission number of medical schools. In 20 years later, the admission number of medical schools will have to be reduced. This is because the physician supply is changing to a linear function and the physician demand (medical care demand) is changing to a quadratic function. Even if the current number is maintained, there will be an excess of doctors from 2048, so the medical school admission number must be reduced and its size will be reduced to about 2,000, a 30% reduction from the current number. Because the same reduction rate for all medical schools will result in many small-scale medical schools, the M&A (mergers and acquisitions) strategy should be considered with 40 medical schools and 12 Korean medical schools. In Korea, the main contributor to estimating physician demand is the change in population structure. Due to the rapid decrease in the total fertility rate, future population projections are uncertain. The recent rapid increase in healthcare utilization should be reexamined in the forecasting of physician demand. Since the various factors that affect the estimate of doctor supply and demand are unclear, the estimate of physician supply and demand must be continuously conducted every five years, and the Health Care Workforce Committee must be established and operated. The effects of increasing the admission number of medical schools should be evaluated and adjusted annually.

Indoor Exposure and Health Risk of Polycyclic Aromatic Hydrocarbons (PAHs) via Public Facilities PM2.5, Korea (II)

  • Kim, Ho-Hyun;Lee, Geon-Woo;Yang, Ji-Yeon;Jeon, Jun-Min;Lee, Woo-Seok;Lim, Jung-Yun;Lee, Han-Seul;Gwak, Yoon-Kyung;Shin, Dong-Chun;Lim, Young-Wook
    • Asian Journal of Atmospheric Environment
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    • v.8 no.1
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    • pp.35-47
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    • 2014
  • The purpose of the study is to evaluate the pollution level (gaseous and particle phase) in the public facilities for the PAHs, non-regulated materials, forecast the risk level by the health risk assessment (HRA) and propose the guideline level. PAH assessments through sampling of particulate matter of diameter < 2.5 ${\mu}m$ ($PM_{2.5}$). The user and worker exposure scenario for the PAHs consists of 24-hour exposure scenario (WIES) assuming the worst case and the normal exposure scenario (MIES) based on the survey. This study investigated 20 PAH substances selected out of 32 substances known to be carcinogenic or potentially carcinogenic. The risk assessment applies major toxic equivalency factor (TEF) proposed from existing studies and estaimates individual Excess Cancer Risk (ECR). The study assesses the fine dusts ($PM_{2.5}$) and the exposure levels of the gaseous and particle PAH materials for 6 spots in each 8 facility, e.g. underground subway stations, child-care facilities, elderly care facilities, super market, indoor parking lot, terminal waiting room, internet caf$\acute{e}$ (PC-rooms), movie theater. For internet caf$\acute{e}$ (PC-rooms) in particular, that marks the highest $PM_{2.5}$ concentration and the average concentration of 10 spots (2 spots for each cafe) is 73.3 ${\mu}g/m^3$ (range: 6.8-185.2 ${\mu}g/m^3$). The high level of $PM_{2.5}$ seen in internet cafes was likely due to indoor smoking in most cases. For the gaseous PAHs, the detection frequency for 4-5 rings shows high and the elements with 6 rings shows low frequency. For the particle PAHs, the detection frequency for 2-3 rings shows low and the elements with 6 rings show high frequency. As a result, it is investigated that the most important PAHs are the naphthalene, acenaphthene and phenanthrene from the study of Kim et al. (2013) and this annual study. The health risk assessment demonstrates that each facility shows the level of $10^{-6}-10^{-4}$. Considering standards and local source of pollution levels, it is judged that the management standard of the benzo (a)pyrene, one of the PAHs, shall be managed with the range of 0.5-1.2 $ng/m^3$. Smoking and ventilation were considered as the most important PAHs exposure associated with public facility $PM_{2.5}$. This study only estimated for inhalation health risk of PAHs and focused on the associated cancer risk, while multiple measurements would be necessary for public health and policy.

The Effect of Combined Cognitive-Motor Learning Program with Mild Cognitive Impairment Elderly Patients (경도인지장애노인 대상 융복합 운동 프로그램의 효과 : 신체 인지 기반 복합 인지-운동 중심)

  • Kim, Soo-Yeon;Baek, Soon-Gi
    • Journal of Digital Convergence
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    • v.13 no.10
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    • pp.587-595
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    • 2015
  • The purpose of this study was to demonstrate exploring the field application of combined cognitive-motor learning program based on proprioceptive neuromuscular facilitation and Bartenieff Fundamental program. The combined cognitive-motor learning program(CC) was applied to the 10 MCI elder while 10 elder in occupational therapy(OT) took cognitive learning class. MMSE-K, Time up & go test(TUG), Tandem gait test(TA), GQOL-D were measured and analyzed. The collected data were analyzed by Independent & Paired T-test. The results were as follows: Both groups showed similar learning effect in MMSE-K test. However, in TA & GQOL-D test, CC group showed significant learning effect than OT group. From these result, we conclude that combined cognitive-motor learning program is valuable as alternative program for cognitive development and social development as well as physical development of MCI elder.

A Study on the Dietary Behaviors of Female Baby Boomers and the Needs for Future Perspectives of Dietary Life (여성 베이비부머들의 식생활 태도와 미래 식생활 요구도 조사)

  • Nam, Haewon;Myung, Choonok;Park, Youngsim
    • The Korean Journal of Food And Nutrition
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    • v.26 no.4
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    • pp.895-908
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    • 2013
  • The purpose of this study is to examine female baby boomers' dietary habits and their attitudes together with their needs for future perspectives of dietary life. Our aim is to use these findings as a basic data when forecasting for food-related industries or policy making. A survey is being carried out for a total of 358 female baby boomers and analyzed by SPSS 12.0. The following is a summary of this study. The average age is 52.6 years old, most of them graduated from highschool (63.1%) and had a nuclear type of family (76.1%). Only 39.0% is composed of housewives, others had either full-time or part-time jobs. Self-assessment of stress is not so high and only 8.1% are dissatisfied with their lives. 38.2% are either overweight or obese in terms of BMI, and most of them are non-smokers (97.2%) or non-drinkers (63.0%). Their mean dietary habit scores are $70.6{\pm}11.8$, and the scores show significant relations with their education levels (p<0.01), monthly income (p<0.01), life satisfaction rates (p<0.001), stress levels (p<0.001), smoking habits (p<0.05), drinking habits (p<0.05), regular exercises (p<0.001) and regular health check-ups (p<0.05). The rate of skipping breakfast, lunch and dinner are 18.2%, 1.1%, 5.2% respectively. The main reason for skipping breakfast is the 'lack of time'. With regards to the frequency of grocery shopping, almost half of the subjects (55.7%) said '1~2 times per week' and bought mainly raw food sources such as vegetables, fruits, and meats. The majority of the subjects (91.3%) report that they cooked meals at homes, and took about 1 hour of time. The subjects also point out that cooking was a bothering task, and only 46.4% would prepare meals at home, while others would rather eat out or eat convenience foods. The main reasons for not wanting meal services in the elderly welfare facility are because they didn't want to live such places (48.4%) and the meals are tasteless (31.3%). As for delivery meal services, 60.1% are aware of it, and 39.9% would consider using it in the future. Factors to be considered when using the delivery meal service are sanitation (43.7%), nutrition (28.7%), taste (18.4%), price (6.3%), and brand name (2.9%). This study is expected to be used as useful information when developing food-related strategies for baby boomers in the future.