• Research in Community and Public Health Nursing
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• v.15 no.4
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• pp.551-565
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• 2004

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.

• Journal of Korean Academy of Nursing Administration
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• v.11 no.1
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• pp.67-77
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• 2005

Purpose: Needs of health-welfare-medical service for the elderly is rapidly increasing in Korea. The purpose of this study was to evaluate the needs of health-welfare-medical service for the long-term care elderly in the community and to compare differences by their characteristics. Method: Needs assessment was completed in the homes of 598 persons over 65 years by using the tool of needs assessment, between November and December, 2003. We examined all the health-welfare-medical service of elderly in the community. Data were analyzed using SAS program. Result: The needs of the long-term care elderly in community was largest 'home visiting service of visiting nurse(87.5%)', and then 'religious, psychological and emotional support(73.9%)', 'home visiting therapy of physician(58.5%)', 'social support service(55.7%)', 'health improvement program of public health center and social welfare center(51.8%)', 'health examination(48.8%)' followed. The difference of health-welfare-medical service needs among characteristics(age, medical security, caregiver existence, and regions) was statistically significant by service contents(p<0.05 or p<0.01). Conclusion: We can apply it in the distribution of community resource and the development of service providing programs by figure out the needs assessment for the long-term care elderly in the community, and consequently, through this, realizing the health maintenance and promotion of the long-term care elderly.

• Journal of Korean Public Health Nursing
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• v.11 no.2
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• pp.57-72
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• 1997

The objectives of this study are : 1) To understand self-care ability, living habits, utilization patterns of medical facililties for the elderly in Puk-Cheju county which has the highest percent age of senior citizens among Cheju rural community: 2) To identify factors which influence living quality and long life for the eldely 3) To develop health care service with a view to guaranteering living quality The eldely population of Puk-Cheju county was $10.8\%$ in 1995. It will be increasing and is projeted $23.0\%$ by 2030. The result indicated that utilizations rate by out-patient were 5.89 claims and utilizations rate by in-patient were 0.17 claims per person. The highest disease among respondents were disease of musculoskeletal system and connective tissue. A total of 310 elderlys were responded to analyze self-care ability and health behavior. The most important factors of long life were to have peaceful mind$(50.0\%)$. The common disease of acute and chronic disease was musculoskeletal system disease. $66.8\%$ of respondents went to hospital and local clinic when they got sick. The most needed health care service was home visiting service among public health center, representing $31.4\%$. The repondent's self-care ability and self-efficacy were relatively superiority. A total of 92 elderlys were conducted the intelligence test for the rate of dementia and their average age was 74.3. The result of Minimental State Scale indicated that 25% of respondents were suspected to be dementia. The followings are recommendations based on the survey result. 1) Concidering every conditions of self-care ability and health status for elderly. It is important to embody appopriate health care service. 2) Considering concrete method, it is necessary to establish health service, which match health status and self-care ability, and various planning for sepecial facilities for the elderly. 3) It is desiable to make actual programs for the elderly in each community level. 4) It must be develop the better use of volunteers and programs for prevention of dementia. Finally, Concerning the orgarnization of public health center, community health center need to be reorganized for health service for the elderly. It is important to develop and operate health promotion for the elderly, and it is necessary to form the foundation for the support of facilities equipments. This contribute to promote health status for the rural elderly.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.5-18
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• 1999

The aim of this study is the development of a fee - based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi -purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.15 no.1
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• pp.37-43
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• 2008

This paper provides the guidelines from which to develop a visiting health care program at the Public Health Center in Korea and involves an expanded payment compensation system of preventive services based on the new long-term health insurance system in Japan. The function and management methods to achieve the goals practiced in a community contact center for elderly support which have recently been established will guide the specific directions and strategies that the Public Health Center should pursue. That is to say, comprehensive and continuous efforts will be put forth in preventive home visiting care targeting the elderly in certain jurisdictions. At this point in time in which the visiting care nursing program has not yet started, visiting health care provided by the Public Health Center oversees chronic diseases of a vulnerable population. But after it has been developed nationwide, the visiting health care system at the Public Health Center will be distinctive and focused on health promotion and prevention.

• Journal of agricultural medicine and community health
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• v.32 no.1
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• pp.27-39
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• 2007

Objectives: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. Methods: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. Results: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. Conclusions: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.

• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.163-180
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• 1998

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.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.44-52
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• 1999

This investigation & study has been made in oder to revitalilize the health care for the elderly in public health centers. The date subject, including 88 persons in charge health services in public heal centers, were from Chejudo. These were largely female, the average age was 38.4 at the health center. Their responsibilities included home visitation, nutrition management for the early, health education, and physical therapy. The most important problem were personal management and a lack of facilities, especially in home visitation, health education, physical therapy. Systematic networks of various activities are needed to encourage not only the patient but also volunteer who will also take part in these services. The numbers of members in charge of the elderly are not only to be increased and educate with facilities and equipment but also better provided with proper facilities and equipment. This is the best way to conduct health services the elderly.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.2-14
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• 1998

The aim of this study was to examine differences in the level of satisfaction with medical care at a public health center between patients receiving free-care compared to those paying out-of-pocket. SERVQUAL(Comprehensive Service Quality Measurement Scale), a pyschometrically valid measure for evaluating hospital service quality, was used to assess patient satisfaction. The study sample consisted of 279 patients who received medical care at a public health center. The interview was conducted between April 23 and May 7, 1998. The results was as follow: 1. There were more elderly people among free-care patients than out-of-pocket patients. Education and income levels were lower amongs those receiving free-care. There were, however, no differences in the distribution of gender and religion between the two groups. Patients receiving free-care tended to visit the public health center more frequently compared to those self-paying patients. 2. Overall, free-care patients showed higher satisfaction level than that of self-paying patients. except for the dimension on sympathy and shape.

• Journal of Korean Public Health Nursing
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• v.11 no.1
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• pp.138-162
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• 1997

This study was conducted to, develop the social workers role participating health and welfare services production of health centers The sharp increase rate on the elderly population in Korea lead the social issues as that health and social services are not developed enough to cope with the increase on the elderly's hearth care needs. The priority in the elderly's care service development should be put on public sectors. so that could prevent financial catastrophy of the elderly's care. The pulbic sector was concerned with health center services : as health center in Korea provide :mainly medical-oriented services. this study focused on to combine the existing health center's services into social services. The study method was based on needs survey with 322 patients aged over than 55 in rural area. "The needs survey include general health and disease care needs and daily life caring needs. The latter was applied with ADL and IADL with modificiation for the use of Korea environment. The findings were as follows : Social workers should be able to care diseases of muscular and skeletal. circulatory, digestive and general chronic disease in social service needs. aspect. Mostly the chronic pateints quit their care services because of shortage of finanical support$(18.3\%)$ and transportation problem$(19.5\%)$, but still prefer to be cured and cared from general hospitals. and at least clinic and health centers in community. The univisible dramatic effect. of health. care services also should be concerned and cared by xocial workers. The ADL and! IADL shown the most needs on transportation needs and problems caused by weaken legs. Mostly daily activities were supported by family members $(53.3\%\;spousers\;and\;35.0\%\;children)$, and the most demands were shown on helps for transportation visiting hospitals$(37\%)$ and getting similar care services for health care needs $(31.2\%)$ and daily hygeieal needs$(11.2\%)$ Social workers' role should include health care participation with social and health promotion approach as well as socio-economic supports: during health care receiving. Social workers also should provide social services for the elderly's daily needs solving for these are not in available family supporters.