• Title/Summary/Keyword: Health Care Inequality

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A Study on Elderly People in Health Inequality in Vulnerable Health Areas Centering around Agriculture and Fisheries Areas (농어촌 건강취약지역 노인의 건강불평등 관련요인 연구)

  • An, Sung A;Sim, Mi Young;Jeong, Baek Geun;Kim, Jang-Rak;Kang, Yun Sik;Park, Ki-Soo;Yeum, Dong Moon
    • 한국노년학
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    • v.31 no.3
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    • pp.673-689
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    • 2011
  • It is a qualitative study based on a focus group with an aim to figure out elderly people's experiences in health inequality in vulnerable health zones in agriculture and fisheries areas. Of eups, myeons and dongs selected as 40 vulnerable areas where standardized death rates had continued to be high from 2004 to 2007 in 20 counties and cities in Gyeongsang-do, 15 agriculture and fisheries areas were randomly chosen to extract 8 to 10 elderly people. Explanations were given to study subjects, and 7 to 8 people who agreed to take part in the study joined a regional focus group. Contents of interviews were analyzed with a phenomenological method by Colaizzi (1978) in order to accurately describe pertinent phenomena. The study has found four categories including ecological environmental problems, insufficient services for local community & harmful environmental problems, worsening economic conditions and insufficient health care management in terms of health behavior.

Effect of Perceptions of Local Neighborhood Environments on the Physical Activity of Children from Low-income Families Using Community Child Care Centers (지역아동센터 이용 아동과 주 양육자의 지역사회 환경에 대한 인식이 아동의 신체활동에 미치는 영향)

  • Park, Jiyoung;Kim, Wansoo;Kim, Soobin;Ryu, Soorack;Jeon, Heejeong
    • Journal of Korean Public Health Nursing
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    • v.32 no.3
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    • pp.363-375
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    • 2018
  • Purpose: The aim of this study was to identify the influence of children's and caregivers' perceptions of local neighborhood environments on children's physical activities (PAs) and screen-based activities (SBAs) among low-income families. Methods: Secondary data analysis was performed using the data of 171 low-income children attending community child care centers and of their caregivers. Descriptive analysis, factor analysis and logistic regression analysis were employed to analyze data. Results: PAs were insufficient and SBAs were excessive in the majority of children. Children and primary caregivers had moderately negative perceptions of their local neighborhood environments. However these perceptions were not found to affect children's PAs or SBAs significantly. Conclusion: Although perceptions of local neighborhoods were not found to significantly influence children's PAs or SBAs, efforts are needed to make community child care centers and neighborhoods safer and more activity-friendly.

Trends of Health Care Utilization and Relevance Index of Stroke Inpatients among The Self-Employed Insured and Their Dependents of National Health Insurance (1998-2005) (국민건강보험 지역가입자 중 뇌졸중 입원환자의 의료이용 양상 및 지역친화도 추이 (1998-2005))

  • Kim, Ji-Hyun;Cho, Byung-Mann;Hwang, In-Kyung;Son, Min-Jeong;Yoon, Tae-Ho
    • Health Policy and Management
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    • v.18 no.4
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    • pp.66-84
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    • 2008
  • Objectives: This study aimed to. offer some fundamental evidences for the stroke management policy by investigating the trends of medical care utilization and regionalization in stroke inpatients. Methods: We used the National Health Insurance claims and registry data for stroke inpatients from 1998 to 2005. Among all stroke inpatient claims data, self-employed insured and their dependents were only included in this study. The classification of stroke was based on ICD-10(I60-I69) and its subtype was divided by hemorrhage(I60-I62) and infarction(I63-I64) type. To evaluate regionalization of medical care utilization, relevance index was calculated by regions. The regions were classified 8 large catchment areas and 163 self authorized areas. Results: The overall medical care utilization rate of stroke inpatient has been increased, especially infarction subtype. Among medical care institutions, the utilization of hospital has been the most rapidly increased. Although considered annual rate of interest, total medical cost of stroke inpatients has been increased, Totally, more than 84% of stroke inpatient were admitted to medical care institutions in their own large catchment area during 1998-2005. The relevance indices in their own large catchment area (self sufficiency rates) were more than 70% in most areas regardless of stroke subtype except Chungbuk catchment area. Self sufficiency rates of stroke inpatients among 163 self authorized areas in 1998 and 2005 were 84.2% and 83.1% in metropolitan, 46.7% and 45.5% in urban, and 19.5% and 22.6% in rural areas, respectively. Conclusion: Stroke management policy for improvement of distribution at the district level, especially in rural areas, may be helpful for reducing regional inequality in stroke.

A Study on the Family Planning Practice of Some Urbanites (일부 도시지역 주민의 가족계획 실천에 관한 연구)

  • Kim, Young-Ha;Cha, Hyung-Hun;Yum, Yong-Tae
    • Journal of agricultural medicine and community health
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    • v.9 no.1
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    • pp.27-38
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    • 1984
  • The Family Planning Project as a birthcontrol policy has been enthusiastically carried out by the government since 1962. But gradually it get less enthusiastic. Therefore, it is required to establish a more comprehensive and systematic plan and to carry out it thoroughly. And it is needless to say that people's knowledge about family planning, their attitudes and their practice should be concretly comprehended. Taking these things into consideration, this study surveys the general situation on family planning among 237 married women of less than 34 years in Guro 6-dong, one of target areas for Korea University Health Project from Sep. 17, 1984 to Oct. 13, 1984. The results are as follows; 1) Most of the subjects (62.8%) want 2 children and 13.6% want one child. But son-preference consciousness is remarkably revealed among them, which is thought to cause social inequality between man and woman. Therefore, it needs to change the traditional son-preference convention, for equality of all men regardless of sex. 2) The rate of induced abortion experience by person is 61.6% and the average frequency is 1.4. Almost all the induced abortion are carried out at clinics and hospitals during 2~3 months after conception. To prevent these unnecessary conception and induced abortion in view of maternal health, ethics and economics, proper contraceptive measures should be emphasized. 3) Temporary contraceptives should be sold more widely in the basis of free trade in order to practice the intensive and comprehensive family planning because the degree which Health Center has been utilized for buying temporary contraceptives is low. 4) There are serious problems such as the side effects and the lack of follow up care in permanent contraceptives. Those lower the practice rate of permanent contraception. Therefore it is necessary to improve the quality of permanent contraception practice and strengthen the follow-up care.

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Relationship between demographic and socioeconomic characteristics of the Korean elderly and unmet dental care needs (한국 노인의 인구·사회경제적 특성과 미 충족 치과진료와의 관련성)

  • Jung, Eun-Seo;Ahn, Geum-Sun
    • Journal of Korean society of Dental Hygiene
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    • v.18 no.6
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    • pp.911-920
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    • 2018
  • Objectives: This study investigated the relationship between demographic and socioeconomic characteristics of the Korean elderly and their unmet dental care needs, by using the 2015 data from the $6^{th}$ Korea National Health and Nutrition Examination Survey (NHANES). Methods: In total, 1,372 elderly persons aged 65 and over, who responded to the $6^{th}$ NHANES, were included in the final analysis. Logistic regression analysis was performed in order to identify any relationship between demographic and socioeconomic characteristics and unmet dental care needs. Results: The rate of unmet dental care needs was shown to be less by 0.799 times in the elderly who reside in dong than those who live in eup and myeon (OR: 0.799, 95% CI: 0.679-0.959). Unmet dental care needs were higher in participants with 'low' and 'below average' than 'above average' income, by 1.645 times (OR: 1.645, 95% CI: 1.087-2.366) and 1.172 times (OR: 1.172, 95% CI: 1.108-1.880), respectively. Elderly individuals living alone had a higher rate of unmet dental care needs than those living with their family by 1.157 times (OR: 1.157, 95% CI: 1.084-1.498). Conclusions: Demographic and socioeconomic factors influenced unmet dental care needs, causing inequality. Proper policy support to the vulnerable should be considered in order to enhance the elderly's access to dental care.

A Scoping Review on the Expected Role of Community Pharmacists in the Era of COVID-19 Pandemic Crisis Across OECD Countries (OECD 회원국에서 COVID-19 팬더믹 위기시대 지역약사의 확장된 역할에 대한 주제범위 문헌고찰)

  • Iyn-Hyang Lee;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.4
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    • pp.288-302
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    • 2022
  • Objective: Community pharmacists are frontline health care providers, but have been considered as underutilized professionals on a daily basis. The purpose of this scoping review was to identify information about the impact of the COVID-19 pandemic on community pharmacy services and to evaluate new services that could be applicable. Methods: We searched MEDLINE and EMBASE for studies published up to January 10, 2020. Search terms consisted of keywords relevant to this review, including "COVID-19", "community pharmacy", and "community pharmacist". This review targeted studies of pharmacist services provided by community pharmacies in OECD member countries during the COVID-19 pandemic period. Results: Twenty-seven studies were included in this review. Changes in community pharmacist services due to the COVID-19 pandemic were broadly classified into four categories. First, as the face-to-face services became challenging, various non-face-to-face services were being tried. Second, community pharmacists directly participated in the services to prevent the spread of COVID-19. Third, community pharmacists made efforts to support continuity of care for patients who experienced difficulties due to the reduced professional care as health and medical resources are concentrated in response to COVID-19. Fourth, community pharmacist services were emerging, targeting patients suffering from greater health inequality during the pandemic. Patients expressed high demand and satisfaction for the service of the community pharmacist, and pharmacists reported self-efficacy and professional pride. Conclusion: This study demonstrated that in the era of the COVID-19 pandemic, various community pharmacist services have been tried and received positive evaluations from patients in several OECD countries.

Human Development Inequality Index and Cancer Pattern: a Global Distributive Study

  • Rezaeian, Shahab;Khazaei, Salman;Khazaei, Somayeh;Mansori, Kamyar;Moghaddam, Ali Sanjari;Ayubi, Erfan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.201-204
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    • 2016
  • This study aimed to quantify associations of the human development inequality (HDI) index with incidence, mortality, and mortality to incidence ratios for eight common cancers among different countries. In this ecological study, data about incidence and mortality rates of cancers was obtained from the Global Cancer Project for 169 countries. HDI indices for the same countries was obtained from the United Nations Development Program (UNDP) database. The concentration index was defined as the covariance between cumulative percentage of cancer indicators (incidence, mortality and mortality to incidence ratio) and the cumulative percentage of economic indicators (country economic rank). Results indicated that incidences of cancers of liver, cervix and esophagus were mainly concentrated in countries with a low HDI index while cancers of lung, breast, colorectum, prostate and stomach were concentrated mainly in countries with a high HDI index. The same pattern was observed for mortality from cancer except for prostate cancer that was more concentrated in countries with a low HDI index. Higher MIRs for all cancers were more concentrated in countries with a low HDI index. It was concluded that patterns of cancer occurrence correlate with care disparities at the country level.

Analysis of the Inequalities in Healthcare Service Usage Considering Healthcare Service Needs (의료필요를 고려한 의료이용의 형평성 분석)

  • Lee, Yong-Jae;Lee, Hyun-Ok;Kim, Hyung-Eick
    • The Journal of the Korea Contents Association
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    • v.17 no.11
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    • pp.435-445
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    • 2017
  • This study was conducted to overcome the limitations of prior research on the equity of medical care performed by identifying simple differences in the use of medical care or using limited medical needs and medical utilization indicators. Specifically, we used activity limits, chronic diseases, and subjective health status as medical needs, and used outpatient, inpatient, and emergency services as medical uses. In addition, we used concentration index, concentration curve, and Le Grand factor to analyze the equity of medical use considering medical needs. The main results are as follows. First, the amount of medical care for the low-income class is higher than that of the high-income class when considering the concentration of medical use. In particular, the number of hospitalization days for low-income households and hospitalization fees were higher than the fees of outpatient medical consultation and emergency room usage. Second, medical needs were concentrated in the low income class. In other words, low-income group is not as healthy as the high-income group. Third, the Le Grand factor was calculated in order to confirm the fairness of the medical uses considering the medical needs. Even if medical needs are taken into consideration, the high-income earners will have a large amount of medical care. In addition, when considering the limitation of activity and the number of chronic diseases, the medical use of the high income class was more frequent. However, when the subjective health condition and the chronic illness were considered, medical use of the low income class was more frequent. This may be due to the underestimation of the medical needs of the low-income earners by neglecting their own health status and perception of chronic diseases.

Case Study on an Oral Health Care Program for Older Adults Based on a Public-Private-Academic Partnership

  • Jin-Sun Choi;Soo-Myoung Bae;Sun-Jung Shin;Bo-Mi Shin;Hye-Young Yoon;Hyo-Jin Lee
    • Journal of dental hygiene science
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    • v.24 no.2
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    • pp.115-123
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    • 2024
  • Background: The population of Gangneung City in South Korea has shown a gradual increase in the proportion of individuals aged 65 years and older, and the most frequently reported diseases for several years have consistently been periodontal diseases, including gingivitis and periodontitis. The regional imbalance in the distribution of dental personnel and resources has emerged as a problem of inequality in the use of dental care. It has been advocated to identify areas with disadvantages in dental care and develop public dental policies based on that. This study aimed to develop a customized oral healthcare program for local seniors based on a Public-Private-Academic Partnership, and to evaluate the oral health status of older adults in Gangneung City. Methods: The participants were residents aged 60 years and above in Gangneung City. A questionnaire including general information, systemic health status, and oral health status was administered to the participants. In addition, oral healthcare and education tailored to each individual's health status were provided once or twice based on their oral health status. The collected data were analyzed using IBM SPSS Statistics 25 for descriptive statistical analysis. Results: Among the older adults in Gangneung City, 75% had at least one prosthesis and exhibited symptoms of gingivitis or periodontitis. Additionally, the modified sulcus bleeding index decreased among participants who underwent the program twice. Over 90% of the participants expressed satisfaction with the program. Conclusion: The program appeared to contribute positively to the oral health promotion among local seniors. Further oral healthcare programs should focus on seniors in rural and old urban areas to reduce disparities in oral health across regions.

Structural Model of health status in Rural Community: Social Trust, Medical Communication, and Health Information (사회적 자본과 건강정보, 의료 커뮤니케이션 요인이 농어촌 지역의 건강상태에 미치는 영향에 대한 구조모델)

  • Jang, Han-Jin;Noh, Ghee-Young
    • Journal of Digital Convergence
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    • v.13 no.8
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    • pp.483-493
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    • 2015
  • Industrialization and urbanization have caused health inequality between rural areas and cities. Health care in rural area is insufficient comparing to urban areas. This study examined the effects of social capital, Health Information, and medical communication factors on Health status in rural community using structural equation modeling. First, social capital has an effect on medical communication with physicians and medical communication impacts on health status. Second, health information orientation has an impact on health behavior and Internet health information. Lastly, health information orientation influenced by Internet health information as a mediator affects health status. As a whole, this study contributes to theoretical explanation about determinants of health status in communities by examining structural path of the effects of social factors and communication factors on health status in rural area.