• Title/Summary/Keyword: Health Service Utilization

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The Knowledge, Attitude, and Utilization Experience of Community Health Practitioners on Complementary Therapies (보완요법에 대한 보건진료원의 지식, 태도와 활용 경험)

  • Hwang, Sung-Ho;Park, Jae-Yong;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.87-105
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    • 2002
  • In order to find out the knowledge, attitude, and experience of community health practitioners(CHP) on complementary therapy, 393 community health practitioners who provide primary health care service in Busan, Kyeongnam, and Daegu, Gyeongbuk regions were interviewed or surveyed by mail from February 1st to March 31st, 2002. In terms of interest of CHPs toward 11 different hinds of complementary therapy, the rate of interest for soojichim was the highest with 75.3%. Aroma therapy had the interest of 71.0% of the CHPs, oriental medicine had 67.4%, and massage had 67.4%. The interest for shiatsu was 64.6%, while homeopath had the lowest rate of interest of 18.1%. In terms of reliance on the treatment results, oriental medicine scored the highest with 92.6%, and soojichim, massage, and shiatsu followed with 85.5%, 83.7%, and 81.7% respectively. Homeopath had the lowest reliance of 18.1%. The 65.1% of the CHPs had the experience of recommending oriental medicine to patients. 50.4% indicated that they had recommended soojichim, and 44.8% had recommended massage before. Shiatsu and aromatherapy followed with 34.4% and Homeopath had the lowest rate of 2.80%. When CHPs were asked if they had received any training in complementary therapy, 33.1% indicated that they had studied soojichim and 13.2%stated that they had learned oriental medicine. Aromatherapy, massage, and shiatsu followed with 11.2%, 8.4%, and 5.6% respectively On the other hand, none of the CHPs had received training in homeopath. In terms of using complementary therapy during the past 5 years, 23.9% had been treated with oriental medicine, and 18.896 had received soojichim. 5.9% had received aromatherapy, 5.3% had used massage, and 5.1% had experience with shiatsu. None of the practitioners had used homeopath during the past 5 years. Significantly many number of practitioners indicated that they had excellent treatment results with all hinds of complementary therapy, and there were rare cares of side effects. When they were asked if they wanted complementary therapy to become part of the curriculum during re-training or training for public service personnels, 78100 wanted soojichim, 69.2% wanted oriental medicine, and 67.9% wanted aroma therapy. 63.9% wanted shiatsu to be included, and 63.1% wanted massage. When CHPs were asked if they wanted to use complementary therapy during primary health care, 63.6% wanted to use soojichim, 52.9% wanted massage, and 51.9% wanted to use aroma therapy. Oriental medicine also showed a high rate of 50.1%. On the other hand, only a small percentage wanted to use chiropractic or homeopath with 17.0% and 12,2% respectively. Among the CHPs, there were some who had administered complementary therapy during the past 5 years. 84% had administered soojichim, 4.6% had administered oriental medicine, and 2.5% had administered massage 2.5% of the CHPs answered that they had administered aromatherapy. However, none of them had administered apitherapy or homeopath. Most of patients showed positive responses, and the rate of side effect was very low. As shown in the above results, although CHPs have a high rate of interest, reliance, and experience in recommending complementary therapy, only a low percentage of them had received any training in complementary therapy. In addition, since there were little side effects when they received or administered complementary therapy, they hoped complementary therapy, which can be beneficial to health, to be introduced to the curriculum. Therefore, in order to provide community members with complementary therapy and the correct information regarding the selection of complementary therapy that could be beneficial to health, a policy of continuous interest and support is needed so that CHPs can he provided with a systemic and rational curriculum of complementary therapy.

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Analysis of Telephone Counseling Service on Child Health (전화 아기건강상담을 통해 나타난 우리나라 어머니들의 육아문제 분석)

  • Song Ji-Ho;Han Kyung-Ja;Oh Ka-Sil;Cho Kyoul-Ja;Lee Ja-Hyung;Park Eun-Sook;Cho Kap-Chul;Tak Young-Nan;Ahn Young-Mee
    • Child Health Nursing Research
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    • v.7 no.2
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    • pp.245-257
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    • 2001
  • This study analyzed the services as operated by the Child Health Telephone Service Center. The Center is a toll free service operated as part of the community services of the Korean Academic Society of Child Health Nursing. The aim of the study was to describe the concerns of child caregivers regarding child health care as discussed during telephone counseling. Specific objectives were as follows: 1. To analyze the activities of the Center. 2. To describe the characteristics of caregivers who made phone calls for counseling services and also the characteristics of their children. 3. To analyze the content of the counseling sessions. 4. To analyze counseling content according to the characteristics of the caregivers and their children. Data used for the study were obtained from the counseling records for the period from Sept. to Dec. 1999, as kept by the three counselors at the Center. The total number of calls was 8,261 and that consisted of 15,150 questions. The total questions were merged into 13,236 by eliminating those questions which overlapped or were of similar content. The final 13,236 questions were used for the final analyses. Almost of the callers (98.4%) were mothers. Among them 89.6% were between 25 and 35 years of age. Geographical distribution of the callers covered the whole nation. The largest numbers who made the calls were from the Seoul metropolitan area (36%), followed by 28% from Kyung Gi Province, and 20% were from the Kyung Sang area. Among 8,261 callers, 72.8% were first users. Sex of the babies and children in question for counseling was about even for males and females and ages ranged from one month to six years. The largest group (62.5%) was the less than six month age group. The finalized 13,236 questions/problems were categorized into 11 problem areas. They were in order of frequency, physical problems, feedings and nutrient concerns, information on child rearing, growth and development, guidance on utilization of child care facilities, elimination problems, sleeping concerns, immunization related concerns, behavior problems, injury and accidents, and safety measures. The most frequent problems for counseling were physical signs and symptoms (27.3%), followed by feeding and nutrients, information on child rearing, and growth and development. Of physical problems, abnormal gastrointestinal signs and symptoms were the most frequent concern and skin problems were next at 25% and 23.3% respectively. Loose bowels, vomiting and constipation were the most frequent gastrointestinal problems. Atopic dermatitis had the highest frequency at 53.3% with diaper rash being the second highest among the skin problems. About 80% of the growth and developmental category were physical development concerns related to physiological, body growth, and motor and sensory development. This study constitutes the activity report for the first year of the Center. The findings correspond with literature reports on child health problems and parents educational needs. One recommendation from this study is that since the services of the Center are carried out only by telephone, the psychology of the counselees and the counselor relationship must be considered for better services.

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Reviews on the Current Status and Appropriate Management of Polypharmacy in South Korea (우리나라의 다제약제 현황과 적정관리 방안에 대한 고찰)

  • Park, Hae-Young;Sohn, Hyun Soon;Kwon, Jin-Won
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.1
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    • pp.1-9
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    • 2018
  • Polypharmacy is increasing owing to an increase in the elderly population and multimorbidities associated with the increased risk of administration of potentially inappropriate medications (PIMs). The negative effects of polypharmacy on various health conditions and aspects, such as fall, fracture, mortality, cognitive function, and dementia, have been reported. The management of excess and inappropriate polypharmacy through proper interventions and local or national guidelines has been highlighted. The purpose of polypharmacy management is to appropriately prescribe medicines that are essential to treat diseases in patients and to avoid inappropriate polypharmacy, such as interactive or duplicate medicines under prescription and PIMs for specific diseases. Community pharmacists in Australia, the EU, USA, and Japan are collaborating with prescribers to review medications to ensure that the patients can be prescribed appropriate medications. The service cost is reimbursed by public or private insurers. A study in the United States has shown that even with medication review costs, the overall medication cost has reduced. In Korea, various projects such as Drug Utilization Review service and safe use of medicines have been conducted; however, no national guidelines or management measures have been established. It is necessary to implement a national long-term plan on polypharmacy management. Furthermore, a phased implementation plan is required. Shortly, active medication review services and education programs for healthcare professionals with the support of the government should be considered in Korea with reference to other countries in order to raise awareness of seriousness and risks of inappropriate polypharmacy.

A Qualitative Research on Self-Awareness and Improvement in Local Food Utilization depending on the Experience of School Dieticians and Nutrition Teachers (학교급식 영양(교)사의 경험에 따른 로컬푸드 이용에 대한 인식 및 발전방향에 관한 질적 연구)

  • Park, Mi-Young;Kim, Soon-Kyung
    • The Korean Journal of Food And Nutrition
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    • v.28 no.4
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    • pp.685-694
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    • 2015
  • In the present study, we conducted in-depth interviews with school dieticians and nutrition teachers to determine the local foods they were aware of and their experiences with local foods. We also aimed to obtain more detailed measures for local food vitalization and suggestions for improvements. In-depth interviews were performed with 8 school dieticians and nutrition teachers, who stated that local food vitalization was needed for school food services, because it could be a foundation for securing safefood products, student healthi mprovements, environmental protection, and the establishment of a general consumption market. However, they were aware of a higher number of disadvantages than advantages in school situations and indicated the deterioration of the quality of food products as the biggest disadvantage. The most-suggested measurement items for local food vitalization in schools included improvement of the food distribution system, expansion of education, information sharing, prevention of monopolies, improvement of food-product quality, and mass production. In addition, it was suggested that school dieticians and nutrition teachers should invest efforts in the development of excellent recipes and varied diets utilizing local foods. Therefore, system supplementation is urgently required in order for school food service officials, and consumers, to efficiently introduce and vitalize local foods. It is also necessary to foster an environment that encourages trust-based relationships with producers to maximize the effect of system supplementation. This would be the foundation for improving the health of students, improving food-service quality, nutrition management, and vitalization of the regional economy in the future, and will positively affect students' food consumption patterns even after they become adults.

Study on Life Style of Health Promotion for the Elderly - Centering on farming villages in Jeollabuk-do Province - (노인들의 건강증진생활양식에 관한 연구 - 전북 농어촌지역을 중심으로 -)

  • Lee Jin-Woo;Chong Myung-Soo;Lee Chun-Woo;Kwon So-Hee;Ko Kwang-Jae;Jeoung Jae-Yeal;Jahng Doo-Sub;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.5 no.2
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    • pp.8-28
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    • 2001
  • This investigation grasps the level and relevant elements of performance of health promotional activities for the elderly in Korea. It provides fundamental data on health promoting projects targeting the elderly population from farming villages. Hence, this study gropes for an effective approach and measures of health promoting programs. The program needs to be developed with a focus on elderly people from farming villages. In addition, it was carried out in order to provide basic data for development of health projects for local communities. Data gathering was based on survey data targeting patients from the free clinic service. Service was rendered for the residents of farming villages, and conducted at the Offices of CheonBuk Province from October 2000 to December 2000. Analytical results were used to examine the health promotional method for the elderly in the aspect of Oriental Medicine. SPSS 9.0 version as well as T-test and ANOVA were used for survey data analysis. Piersons correlation coefficient was utilized for the relationship for each area, obtaining the following analytical results. 1. The average score for the activities of health promotion was 2.28. Looking at each subcategory, stress management was the highest at 3.65; interpersonal relationship, 3.00; nutrition, 2.55; health responsibility, 2.15; self-realization, 2.03; and exercise was the lowest at 1.89. 2. With respect to lifestyle of the health promotion secondary to general features of elderly people from farming villages, the level of activities of health promoting lifestyle was shown to be higher for males than that of females. Self-realization area was high among males in detailed particulars while the level of execution was high as age decreases in the stress area. 3. Regarding health promoting life style secondary to socioeconomic characteristics, the level of execution was higher for the individuals with a higher level of education and further utilization of spare time. With respect to occupation, the level was highest for people from the fishery. The level decreased in the order of other occupations such as trade, unemployed and agriculture, which was shown to be the lowest. In detailed particulars, it revealed that higher the individuals educational level, the higher the self-realization and stress management areas. The level of interpersonal relationship was the highest among people with little or no education. With respect to self-realization area, the level was highest among the cases where one paid living expenses along with their children. The lowest level of living expenses was seen in the cases where an individual pays for living expenses by himself/herself. There were significant results in all areas except for nutrition areas depending on occupation. The fishery was shown to be the highest. The level of activities was higher as one utilizes more spare time in all areas except for the area of interpersonal relationship.

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Changes in National Health Insurance Medical Expenses and Long-Term Care Costs between the Long-Term Care Group and General Older Adults Group before and after Long-Term Care Use (노인장기요양급여 이용 전후 장기요양군과 일반노인군 간 국민건강보험 및 노인장기요양보험 비용 추이)

  • Seung-Jin Oh;Kang Ju Son
    • Health Policy and Management
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    • v.34 no.3
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    • pp.249-260
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    • 2024
  • Background: The Republic of Korea's aging population escalates medical and long-term care costs. While prior research has suggested that long-term care might reduce these costs, these studies had limitations in their subjects and duration, making it difficult to generalize the results. This study aims to evaluate cost changes between the long-term care group and the general older adults group after addressing these limitations. Methods: A cohort was derived from the 2015 national population using stratified sampling. Subsequently, 15,114 individuals (7,557 in each group) were identified through 1:1 propensity score matching. The study employed a difference-in-differences analysis to explore variances in medical costs and long-term care benefits post-utilization of long-term care services. Results: Compared to the general older adults group, the long-term care group experienced a reduction in monthly per capita total medical costs by 56,459 Korean won (KRW). Although costs at tertiary and general hospitals increased, those related to long-term care hospitals decreased by 90,687 KRW. Including long-term care benefits, overall expenditures increased by 948,038 KRW. Conclusion: The analysis reveals that the long-term care group faces higher medical costs in acute care than the general older adults group, emphasizing a greater need for medical services within this group. To meet the increasing medical demands of the long-term care group, a collaborative strategy linking community resources, healthcare, and long-term care facilities is imperative. Additionally, developing and implementing preventive health habit management strategies for middle-aged and older adults is essential to diminish the future requirement for long-term care.

Development and Application of a Community-based Meal Program Model for the Elderly in Rural Area (농촌지역 노인을 위한 공동 급식프로그램 개발을 위한 시범급식사업 결과의 적용 방안 연구)

  • Heo, Young-Ran;Shin, Jun-Ho;Kim, Kyung-Sun;Kim, Bok-Hee
    • Journal of the Korean Dietetic Association
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    • v.14 no.1
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    • pp.23-35
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    • 2008
  • Improved nutritional intake contributes to maintaining health and quality of life in elderly population and also reducing individual and social medical costs. Most of nutrition assistance programs for elderly, such as congregate or home-delivered meal programs, are not currently serviced in rural communities mainly due to low cost efficiency of program operation. However, the needs and necessity of such programs are presumed to be higher in rural area where the population density of elderly at nutritional risk is relatively high. Therefore, the purpose of this study was to develop a community-based meal program for the rural elderly. In 2007, four rural communities located in Jeon-Nam province were selected and the pilot meal program was applied for three months. Following are key features of the meal program model developed in this study: 1) meal production and service are operated by elderly participants to overcome the voluntary personnel shortage 2) utilization of locally-produced foods is maximized to reduce the meal cost, 3) traditional cooking methods are applied to adjust the food preference of elderly, and 4) foods are serviced on site to minimize the food safety problem possibly caused by delivery process. The pilot programs resulted in high satisfaction with the programs of participating elderly. The community-based meal program model developed in this study is expected to be used as an effective nutrition and health intervention model for the rural elderly.

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The Escalation of Medical Aid Expenditure and the Degree of Contribution of Its Components in Korea(1992~1999) (의료보호 진료비의 증가양상과 진료비 구성요소별 기여도 변화 -1992년부터 1999년까지 의료보호 진료비청구자료를 중심으로-)

  • 신영전;유원섭;염용권
    • Health Policy and Management
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    • v.11 no.3
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    • pp.46-70
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    • 2001
  • Medical Aid expenditure Increased rapidly at a higher rate than that of Medical Insurance during the period 1992-1999. To establish an effective cost containment strategy, knowledge of the cause and the nature of the increase of Medical Aid expenditure is required. The purpose of this study was to analyze increasing rates of Medical Aid expenditure by the components of medical expenses. Data were collected using the Medical Aid Statistical Yearbook during the period of 1992-1999. The major findings were as follows: 1. The annual mean increasing rate of Medical Aid expenditure between 1992 and 1999 was 22.8%, which exceeding that of Medical Insurance expenditure (17.5%) between 1992 and 1999. Since 1998, Medical Aid expenditure increased even more rapidly than in previous years, with the increase in number of Medical Aid beneficiaries. 2. Of Medical Aid expenditure, that of inpatient and outpatient annually increased 24.2% and 22.8% respectively and that of type 1 and type 2 increased annually 28.8% (outpatient) ∼29.9% (inpatient), 14.3% (outpatient) ∼ 15.5% (inpatient). Therefore, Medical Aid expenditure of inpatient and type 1 led the increase of Medical Aid expenditure. 3. Between 1992 and 1997, the frequencies of utilization per beneficiary and the charges per case positively contributed to the increase of Medical Aid expenditure while the number of beneficiaries contributed negatively, but since 1998, the number of beneficiaries increased and positively contributed to the increase of Medical Aid expenditure. 4. According to the analysis of the charges per case, the increase of the price index led to the increase of the charges per case but the days of medication and service intensity also contributed to the increase of the charges per case variably by year. Considering the above findings, factors associated with the Medical Aid system affected the increase of Medical Aid expenditure in addition to the general factors of the increase in medical expenditure. In conclusion, it appears that a more intensive cost containment strategy is required to control rapidly increasing Medical Aid expenditure. For this, more precise analysis and development of policy considering the effect of the number of beneficiaries and the increase of price index is needed.

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Effects of a Smart Phone Weight Loss Program on Obesity and Body Composition in Adolescents (스마트폰 앱을 이용한 체중감량 프로그램이 고교생의 비만도와 신체조성에 미치는 효과)

  • Jun, Min Kyung;Ha, Ju Young
    • Journal of Korean Public Health Nursing
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    • v.27 no.1
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    • pp.102-112
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    • 2013
  • Purpose: The purpose of this study was to determine the effects of a weight loss program administered through a smart phone application on body composition and obesity in adolescents. Methods: This study applied a 6-week weight loss program with dietary education, exercise therapy, and behavior modification therapy from 4 June 2012 to 20 July 2012. The collected data were analyzed by descriptive statistics and the Wilcoxon signed rank test using the SPSS WIN 18.0 program. Results: After the 6-week program, the average weight of the subjects was reduced from 75.96kg to 74.41kg (Z=$-3.994^p$, p<.001), while the body mass index (BMI) decreased from 29.23 to 28.60 (Z=$-3.980^p$, p<.001), and the obesity index decreased from 38.45% to 35.59% (Z=$-3.977^p$, p<.001). The percentage of body fat decreased from 32.45 to 31.92 (Z=$-3.947^p$, p<.001), and the rate of skeletal muscle growth increased from 26.06% to 26.58% (Z=$-3.822^p$, p<.001). Conclusion: A weight loss program using a SNS (social network service) application, with dietary education, exercise therapy, and behavior modification therapy can reduce obesity and impact body composition in a short-term. Therefore, the utilization of the SNS application can be used to effectively enhance the management of adolescent obesity.

The Real Picture of the Care Costs Paid to Korean Oncology Advanced Practice Nurses (종양전문간호사 업무에 대한 수가 실태)

  • Kim, Dal-Sook;Kim, Soo-Hyun;Kim, Kwang-Sung;Jun, Myung-Hee;Kim, Jin-Hyun;Lee, Hyun-Joo
    • Asian Oncology Nursing
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    • v.11 no.2
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    • pp.155-162
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    • 2011
  • Purpose: The purpose of this study was to examine the actual care costs paid to Korean Oncology Advanced Practice Nurses (KOAPN). Methods: We collected data using a group discussion and questionnaire identified 115 tasks from job descriptions developed by the Korean Accreditation Board of Nursing. Forty-two KOAPN working at three university hospitals in Seoul were asked to evaluate each task as to type and whether the cost is paid or not. They were also asked to indicate the tasks in urgent need of development of a care cost with high priority. Results: Only five tasks (4.3%) related to treatment and complication related interventions or education were paid, and they were paid only once during the entire treatment period and were not covered by national health insurance. It was approved as a medical fee by health insurance review & assessment service. Furthermore, the names of the authority (doctor) and the actual provider (nurse) of the prescriptions were different for three of those tasks. Most of the suggested tasks needing development of care costs were actions specifically performed by nurses (physical-psychosocial-spiritual assessment, independent nursing interventions). Conclusion: KOAPN are currently paid for few tasks. To maximize the utilization of KOAPN, the establishment of a clear rational payment system directly related to their actual activities is needed.