The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.
Purpose: This study was conducted to evaluate the economic efficiency of a community-based nursing care center to help policy makers determine whether or not to invest in similar facilities. Methods: The subjects were 101 elderly people over 65 years who participated in a health management program from February 1 to July 31, 2007. Direct cost was estimated with center operations cost, medical cost for out-patients and pharmacy cost. Indirect cost was measured by transportation cost. Direct benefit was calculated by saved medical cost for out-patients, saved pharmacy cost, saved transportation cost, and reducing hospital charges. Indirect benefit was estimated with prevention of severe complications. Economic efficiency was evaluated by cost-benefit ratio and net benefit. Results: Operating a community-based nursing care center was found to be cost-effective. Specifically, the cost of operating the center evaluated here was estimated at 135 million won while the benefit was estimated at 187 million won. Benefit-cost ratio was 1.38. Conclusion: The Community-based nursing care center that was described here could be a useful health care delivery system for reducing medical expenditures.
Purpose: This descriptive study examined the management status of the home health care visiting vehicles and the nurse bags, by the home health care center of hospitals (at the hospital level or higher) in Korea, and identified the relevant factors. Methods: Of 120 managers or home health care nurses from medical institutions at hospital level or higher that provide home nursing, 93 individuals participated in the study in July 2021. Results: Hospitals that followed standard guidelines were more likely to perform internal disinfection of home health care visiting vehicles, and distinguished between clean and contaminated areas inside the visiting vehicles. Further, hospitals that followed standard guidelines were more likely to use more barrier surfaces to protect the surfaces of nurse bags to prevent infection. In addition, hospitals supporting the washing cost of the interior of home health care visiting vehicles were more likely to conduct the washing, and hospitals supporting nurse bags were more likely to use barrier surfaces to protect the bags' surfaces. Conclusion: This study only investigated home health care centers at hospital level or higher. Therefore, to generalize the results of the study, it is necessary to conduct a qualitative study involving additional investigation of home health care visiting vehicles and nurse bags and interviews with nurses from all domestic home health care centers.
Objectives : This study characterized the extent to which youth depressive symptoms, parental alcohol problems, and parental drinking account for differences in alcohol-related problems among a large sample of adolescent females. Methods : The stratified sample consists of 2077 adolescent females from twelve female-only high schools located in a large metropolitan city in the Republic of Korea. Students completed a questionnaire about alcohol use and alcohol problems, their parents' alcohol problems, and a number of risk and protective factors. Data were analyzed using tobit regression analyses to better characterize the associations among variables. Results : Almost two-thirds of students who consume alcohol had experienced at least one to two alcohol-related problems in their lives and 54.6% reported at least one current symptom of depression, with nearly one-third reporting two depressive symptoms. Two-thirds of the students indicated that at least one parent had an alcohol-related problem, and that approximately 29% had experienced several problems. Results of tobit regression analyses indicate that youth alcohol-related problems are positively associated with depressive symptoms (p<0.01) and parent drinking problems (p<0.05). Parental drinking is no longer significant when the variable parental attention is added to the model. Decomposition of the tobit parameters shows that for every unit of increase in depressive symptoms and in parent drinking problems, the probability of a youth experiencing alcohol problems increases by 6% and 1%, respectively. For every unit of increase in parental attention, the probability of youth experiencing drinking problems decreases by 5%. Conclusions : This study presents evidence that alcohol-related problems and depressive symptoms are highly prevalent among adolescent females. Although a comprehensive public health approach is needed to address drinking and mental health problems, different interventions are needed to target factors associated with initiation of alcohol problems and those associated with increased alcohol problems among those who already began experiencing such problems.
Purpose: To investigate the health status such as growth, nutrition, disease, vaccination in child day care centers. Methods: A cross-sectional descriptive study was conducted on 280 children at 6 day care centers in Seoul. Parent completed a structured questionnaire and illness-logs from day-care staff were gathered for a month, June 2006. Body weight, height were measured and BMI was calculated. Results: Failure of growth was found in 2.2% of the children. Also there was 5.4% of the children who were under 5% and 8.6% were above 95% on BMI chart. For 4.3% of the children diseases were asthma, chronic rhinitis, sinusitis and so on. About six percent of the children missed vaccination such as Japanese encephalitis, DTaP and polio. Incidence rates of respiratory infection was 1.45 and gastroenteritis was .28. As a result, 22.5 % of the day care children had these kinds of health rick factors stated above and results showed statistical difference between health-groups and health-risk groups in age, duration of day care center, family structure, marital status of parent. Conclusion: A considerable number of the children at child daycare centers had the health risk factors. These results shows there is a need to develop and make provisions for health service programs by health experts in child day care centers.
Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.
Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients' greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion: We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.
Purpose: The aim of this study was to identify the effects of home visiting care program provided by public health center in control of blood sugar for patients with diabetes mellitus who were cared for at home. Method: The subjects were 50 randomly selected diabetics registered at S-Gu Public Health Center. The program comprised in-person education and home visitations; and telephone contact to educate, monitor diet, exercise, blood sugar, and provide consultation. The control group was provided home visitation by only home calls nurses. The program ran from July 7. 2008 to September 12. 2008. Result: After the program, glycated hemoglobin was decreased in the experimental and control groups; the difference in those receiving home care was not statistically significant. Changes on blood cholesterol in experimental group and control groups were not statistically different. Self-efficacy and self-care performance were increased in those receiving home care. Conclusion: While not statistically significant in this small-scale study, home care for diabetes mellitus patients may promote an increased patient responsibility for self-care that is important in their long-term health.
Purpose: We analyzed the health care and health status of immigrant women married to Koreans in our community. Methods: We recruited 204 women who live in S Cityfrom 1st August to 30th September, 2008. A cross-sectional descriptive survey was done using a questionnaire through interviews and physical assessment by visiting nurses. Results: The average age of the subjects was 29.8 and most of them were housewives. Sixteen percent of them obese as measured by BMI. Moreover, most participants (86%) did not exercise at all. Over 13% complained of physical discomfort that was left untreated, and only 50% participated in cancer screening. Conclusions: Young, obese immigrant women require further health care monitoring. Caregivers also should ask about physical discomfort and cancer screenings. However, caregivers should do so in a culturally sensitive manner. In addition, the government should support cancer detection programs for immigrant women.
Purpose: The purpose of this study was to investigate the effect of health literacy and unmet health care needs on health promotion behaviors among elderly people receiving visiting health care services at community health centers. Methods: The subjects of this study were 180 elderly people over 65 years old who were receiving health care services at public health center The subjects fully understood the purpose of this study and voluntarily agreed to participate. The collected data were analyzed by frequency, percentage, mean, standard deviation, independent t-test, one-way ANOVA, Scheffé test and Hierarchical Regression Analysis using the SPSS 23.0 program. Results: Hierarchical regression analysis was used to identify factors influencing health promotion behaviors of the subjects. The results were as follows: presence of occupation (β=.26, p<.001), social activity status (β=.26, p=.001), and health literacy (β=.16, p=.023). Conclusion: Therefore, in order to improve health promotion behaviors, it is necessary for visiting nurses to administer health education and programs by considering the level of health care understanding.
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