Purpose: The prescription drug list for primary treatment by community health practitioners has been maintained for 30 years without any modification. Thus, this study will suggest an improvement scheme of prescription drug list for primary health care posts through an analysis of drug use in those posts. Methods: A questionnaire survey was implemented with community health practitioners from April to June in 2012. A total of 1,249 copies were analyzed. As for the databases of drug use in the integrated information, a total of 154,229 diagnoses selected in the method of stratified cluster sampling from 39 primary health care posts' data were analyzed. We consulted some experts about the prescription medication list, and referred to the medication information on-line home page for up-to-date drug information. Results: This study ultimately suggests 77 prescription drug items for primary health care posts by eliminating 35 items and replacing 1 item from the original list, and adding 4 items to it. Conclusion: This study will provide basic data for revising the prescription drug list in primary health care posts by periodically reflecting adverse effects in the existing drugs, demographic and environmental changes, and development of new drugs.
Physicians, in order to study the causes of cancer, detect cancer earlier, prevent or determine the effectiveness of treatment, and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive, and timely cancer data. The cancer care environment has become more complex because of the need for coordination and communication among health care professionals with different skills in a variety of roles and the existence of large amounts of data with various formats. The goals of health care systems in such a complex environment are correct health data management, providing appropriate information needs of users to enhance the integrity and quality of health care, timely access to accurate information and reducing medical errors. These roles in new systems with use of agents efficiently perform well. Because of the potential capability of agent systems to solve complex and dynamic health problems, health care system, in order to gain full advantage of E- health, steps must be taken to make use of this technology. Multi-agent systems have effective roles in health service quality improvement especially in telemedicine, emergency situations and management of chronic diseases such as cancer. In the design and implementation of agent based systems, planning items such as information confidentiality and privacy, architecture, communication standards, ethical and legal aspects, identification opportunities and barriers should be considered. It should be noted that usage of agent systems only with a technical view is associated with many problems such as lack of user acceptance. The aim of this commentary is to survey applications, opportunities and barriers of this new artificial intelligence tool for cancer care information as an approach to improve cancer care management.
Purpose: This study was conducted to identify the status and risk factors for the carriage of multidrug-resistant organisms carriage in home health nursing patients. Methods: This retrospective study enrolled 122 participants who received home health nursing and analyzed the data obtained from chart review and diagnostic tests for multidrug-resistant organisms carriage from January 2019 to January 2021. Results: Multivariate analysis revealed that surgical procedures in the preceding year, injectable antibiotic use in the preceding month, pressure ulcer, and indwelling nasal tubes were significantly associated with multi-drug resistant infection. Conclusions: Infection-control strategies need to be developed and customized for use in the home health-nursing service for patients who are carriers of multidrug-resistant organisms.
Purpose: The purpose of this paper is to derive implication on the adoption of PROMs (Patient-Reported Outcome Measures) to improve quality of care in South Korea. With this purpose, the paper examines the status of PROMs in South Korea and other countries including OECD's PaRIS (Patient Reported Indicators Survey) initiative, and reviews policy cases that have adopted PROMs to improve performance of healthcare system. Methods: We conducted literature review on OECD reports on PaRIS, peer-reviewed journals, and information from the websites of relevant institutions such as ICHOM, NQF and OECD. Results: To identify healthcare services of best values and support patient-centered health system, OECD has initiated PaRIS which develops, collects and analyzes patient-reported indicators for cross-countries comparison. PaRIS is implemented on two work streams: 1) collect, validate and standardize PROMs in the areas where patient-reported indicators already exist such as breast cancers, hip and knee replacement, and mental conditions, 2) develop a new international survey on multiple chronic conditions. Countries like England, U.S., Sweden and Netherlands use PROMs for measuring performance of hospitals and performance evaluation at the national level, and provide the financial incentives for reporting PROMs. Conclusions: The use of PROMs can support the current policy agenda that is the patient-centered healthcare system which has been emphasized to reinforce the primary and the community-based care. For the use of PROMs, it is recommended to actively participate in PaRIS initiative by OECD, select appropriate instruments for PROMs, and continue on standardization of them. This will assure patients' involvement in improving health system performance, systemize information generated in the process of adopting PROMs, and develop a system to evaluate performance.
Purpose: This study was to identify health behavior, health service use, and health related quality of life of adult women in one-person and multi-person households. Methods: It was used data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII-2017). Subjects were 2,522 women with age of 19 to 64 years in 2017. Complex sampling design and data analysis were performed using SPSS 20.1. Results: Women in one-person households had higher rates of alcohol drinking (${\chi}^2=13.77$, p=.003), smoking (${\chi}^2=16.07$, p=.001), unmet medical care (${\chi}^2=8.77$, p=.004) and non-practice of cancer screening (${\chi}^2=13.77$, p=.003) compared to women in multi-person households. Health-related quality of life was also lower for women in one-person households (t=-2.46, p=.015). Factors affecting health-related quality of life in one-person households were household income, job status, and unmet dental care, having 32.4% explanatory power. One-person household women with low incomes, no jobs, and unmet dental care showed low health-related quality of life. In comparison, factors affecting health-related quality of life of women in multi-person household women were age, education level, unmet medical care, and unmet dental care, having 10.4% explaining power. Women in multi-person households with age of 60-64, low education level, unmet medical care, and unmet dental care showed low health-related quality of life. Conclusion: Health promotion strategies should be developed based on unique understanding of social, economic, and health of adult women in one-person and multi-person households.
Purpose: This study was to investigate oral hygiene knowledge and the actual condition of oral care for the students in the public health and non-public health Departments. Methods: The survey sample consisted of 262 randomly selected students. 197 of them are public health-related students and 65 are non-public health-related students. The questionnaires used in this study consisted of 4 items for general information, oral health status of 2 items, 5 items for Oral hygiene knowledge and actual condition of oral care of 5 items. Collected data were analyzed by Frequency Analysis t-test and Crosstabs using SPSS(Statistical Package for Social Sciences) Win 19.0 statistics program. Results: Regarding general characteristics of the subjects, there were 53.8% of first-year student, 26.0% of second-year student and 20.2% of third-year student among 52.3% of males and 47.7% of females. The subjects received less than "100,000" won(13.0%), "100,000-190,000" won (5.0%), "200,000-290,000" won(30.9%), "300,000-390,000" won (33.2%) and more than "400,000" won(17.9%) a month for an allowance. The subjects had 'none' (44.3%), '1'(6.5%), '2'(12.6%), '3'(5.0%), '4'(5.3%), 'more than' 5(0.8%) of dental caries and 'do not know' were 25.6%. The numbers of dental prosthetics were 'no' (35.5%), '1'(13.7%), '2'(17.2%), '3'(10.3%), '4'(11.5%), and 'more than 5'(11.8%). The public health students(84.8%) had a higher positive response rate than the non-public health students(66.2%). The public health students(80.2%) had a higher negative response rate than the non-public health students(78.5%) in the result of onset of gum disease pain awareness. The non-public health students(65.5%) had a higher negative response rate than the public health students(68.3%)) in the result of heredity of gum disease. The t-test showed that public health-related department students(M=8.264, SD=0.821) had more knowledge about oral hygiene than non-public health-related department students(M=8.015, SD=1.082). 'do not use' in the oral care products except toothpaste and toothbrush showed that public health-related department students(60.4%) use the products more than non-public health-related department students(66.2%). Conclusion: In this study, public health-related department students had higher oral hygiene knowledge and actual condition of oral care compared to non-public health-related students, but low in practical action. Due to the lower level of dental care products use in non-public health-related department, a continuous oral care education program is required.
The effects of regional health insurance on access to ambulatory care are examined in this paper. Access is measured as use-disability ratios. The data are collected in a household interview survey at Hwachon county before and after the introduction of regional health insurance. Before the introduction of regional health insurance, low-income class has less contacts with physicians than high-income class. This disparity in accessibility among economic classes is reduced with the health insurance coverage, but not removed, even after adjusting for health need.
Background: The purpose of this study was to analyze the association between areas of Korea Train Express (KTX) region and external medical service use in Korean society using spatial statistical model. Methods: The data which was used in this study was extracted from 2011 regional health care utilization statistics and health insurance key statistics from National Health Insurance Corporation. A total spatial units of 229 districts (si-gun-gu) were included in this study and spatial area was all parts of the country excepted Jeju, Ulleungdo island. We conducted Kruskal-Wallis test, correlation, Moran's I and hot-spot analysis. And after, ordinary linear regression, spatial lag, spatial error analysis was performed in order to find factors which were associated with external medical service use. The data was processed by SAS ver. 9.1 and Geoda095i (windows). Results: Moran's I of health insurance patients' external medical service use was 0.644. Also, population density, Seoul region, doctor factors positively associated with health insurance patients' external medical service. In contrast, average age, health care organization per 100 thousand were negatively associated with health insurance patients' external medical service use. Conclusion: The finding of this study suggested that health insurance patient's external medical service use correlated for seoul region in korea. The study results imply the need for more attention medical needs in the region (si-gun-gu unit) for health insurance patients of seoul region. It is important to adapt strategy to activation of primary health care as well as enhancing public health institution for prevent leakage of patients to other areas.
Objectives: This study aimed to provide basic data for future development and promotion of oral health care educational material. We examined the perception of teachers and parents on the use of smartphone applications as educational materials and the factors affecting the intent to use such materials in infants and toddlers. Methods: Teachers and parents of children enrolled in educational institutions in Seoul and Gyeonggi Province, Korea, participated in this study for a one-month period starting from August 2018. Results: The intent to use a freely available smartphone application for oral health education in infants and toddlers was high for both parents and teachers at 81.7% and 78.4%, respectively. The intent to use increased 10.089-fold when a child had unrestricted access to mobile devices, and 4.435-fold when the execution path required modification; however, the ease of use was not compromised. Additionally, the intent to use also increased 2.488-fold when a child had used an educational oral healthcare material that is currently available, and by 2.431-fold and 2.219-fold when a child had previous experiences with an educational mobile application developed for infants and toddlers. Conclusions: Our findings showed that the teachers and parents had a positive perception towards the use of mobile applications for oral health care education in infants and toddlers. We recommend the development and promotion of mobile-based educational applications on oral health care, which are tailored to the needs and oral characteristics of infants and toddlers to help develop good oral care habits.
Background: Few studies have examined the performance of the public long-term care insurance (LTCI) from the perspective of geographic equity. This study investigated regional variations and associated factors in the supply and utilization of nursing home care within and also between Japan and Korea. Methods: A comparative dataset was developed by extracting data from 2013-2015 LTCI statistics yearbooks and Organization for Economic Cooperation and Development regional statistics, as well as other comparable data in Japan and Korea. The unit of analysis was the prefecture in Japan and the province in Korea. We computed variation indices and conducted regression analyses for regional variations within each country and decomposition analyses to examine the variations between the countries. Results: The overall regional supply and use of nursing home care were higher in Japan, but the regional variations in Korea were larger than in Japan. In both countries, the nursing home supply was negatively associated with the proportion of older people with independent living. Nursing home use was also negatively associated with the supply of hospital beds and home care agencies in Korea; the relationship was the opposite in Japan, however. The country-based differences were more likely to be explained by differences in the distributions of the variables included in the analytical model than country-specific characteristics. Conclusion: Regional-level nursing home supply and use were unequal in both countries, and the contributing factors were not the same. Policy efforts are needed to advance regional equality in long-term care (LTC) and collaboration between health and LTC institutions for frail older people, especially in Korea.
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