Purpose: The purpose of this study was to estimate the demand and supply of visiting nursing services provided by health centers in urban area, aiming at strengthening infrastructure, which may improved the quality of life and health status of vulnerable population in the community. Methods: This study was conducted through nominal group discussion, focus group study. The demand and supply of visiting nursing were estimated by health economists based on the secondary analysis data from 25 health centers in Seoul. Result: Primary targets for the visiting nursing must be people who are homebound in the community. They can be classified into: a group of Level I: chronic patients who need visiting nursing care at least once a week: and a group of Level II: vulnerable families that need management periodically e. g. twice a month. Based on the estimation of demand for visiting nursing services in the community, the estimated supply required was $651{\sim}770$ visiting nurses including home health nurses in visiting nursing programs based on health centers in Seoul. Conclusions: The estimated demand and supply of visiting nursing are expected to provide basic data for establishing alternative policies on visiting nursing infrastructure that might be accomplished through demand-based visiting nursing programs by districts.
The Korean health care system is under great controversy. Over the last 30 years, main goal of health policies was to pursue equal access of health care services. However, another goal of health policies laid on efficiency and Quality of care, it had lower priorities. Superficially, controversy stems from priority setting among goals of health care system, equity, efficiency and quality. At a deeper level, arguments arise from disagreement and confusion about the values of Korean health care system. One of the value spectrums believes that health care is the basic right of human beings, therefore it should be produced and distributed on need approach, and needs are known to be decided by professionals. If we accept need approach, health care is a pubic good. Another value of spectrums considers that health care should be distributed on demand approach. Demand approach means that health care is a consumption good on the positive economics, while normative judgement believes that health care is a public good. In equity aspect, health care is considered as a public good. Over the last several years, some of scholars proposed health care reform based on the principle of competition which is based on demand approach. Others argue that the competition principle based on demand approach is not appropriate for the reform proposal, because health care has to be approached on need base. If we do not make explicit values we should adopt, consensus building for reform is nearly impossible. From this perspective, this article will review an ideology and reality in health policies in Korea.
Journal of The Korean Society of Integrative Medicine
/
v.6
no.4
/
pp.149-169
/
2018
Purpose : This study was to develop a strategy for modeling future workforce projections to serve as a basis for analyzing annual supply of and demand for physical therapists across the South Korea into 2030. Methods : In-and-out movement model was used to project the supply of physical therapists. The demand was projected according to the demand-based method which consists of four-stages such as estimation of the utilization rate of the base year, forecasting of health care utilization of the target years, forecasting of the requirements of clinical physical therapists and non-clinical physical therapists based on the projected physical therapists. Results : Based on the current productivity standards, there will be oversupply of 39,007 to 40,875 physical therapists under the demand scenario of average rate in 2030, undersupply of 44,663 to 49,885 under the demand scenario of logistic model, oversupply of 16,378 to 19,100 under the demand scenario of logarithm, and oversupply of 18,185 to 20,839 under the demand scenario of auto-regressive moving average (ARIMA) model in 2030. Conclusion : The result of this projection suggests that the direction and degree of supply of and demand for physical therapists varied depending on physical therapists productivity and utilization growth scenarios. However, the need for introduction of a professional physical therapist system and the need to provide long-term care rehabilitation services are actively being discussed in entering the aging society. If community rehabilitation programs for rehabilitation of disabled people and the elderly are activated, the demand of physical therapists will increase, especially for elderly people. Therefore, healthcare policy should focus on establishing rehabilitation service infrastructure suitable for an aging society, providing high-quality physical therapy services, and effective utilization of physical therapists.
Objectives: This study was conducted to prepare basic data to propose the necessity and utilization of oral welfare products in the welfare services of the long-term care insurance system, focusing on facility workers working in elderly facilities. Methods: The analysis was conducted on 144 workers working at some local elderly facilities. The questionnaire was constructed by classifying the use of oral welfare tools into 6 questions and the necessity and demand for oral welfare devices into 13 questions. Frequency analysis and technical analysis were performed for data analysis, and one-way ANOVA was performed for differences in the necessity and demand for oral welfare equipment. The statistical significance level was p<0.05. Results: As a result of examining the awareness of the necessity and demand for oral welfare equipment among workers in elderly facilities, the awareness of the necessity of including oral welfare equipment in the items of welfare equipment in the current long-term care insurance system was high at 4.15 points. As a result of analyzing the correlation between awareness of care products and the need and demand for oral welfare equipment, it was confirmed that there was a statistically significant positive correlation (p<0.01). Conclusions: In the long-term care insurance system for the elderly, oral welfare products need to be considered for welfare equipment services. The provision of oral welfare products within the long-term care insurance system for the elderly can provide opportunities and services to select various self-care tools. In addition, it is expected that it will be possible to promote changes in the long-term care insurance system for the elderly and to improve the system in a variety of positive ways.
Purpose: This study attempted to estimate the need for home visiting nurse at public health centers. Methods: A model was generated to estimate a community's home visiting health service needs in 16 regions and a workload analysis was adopted to estimate the number of required Nurses. Data were collected from 16 public health centers using the South Korean government's open-information systems. Subjects were divided into three groups: vulnerable social group, bottom 10% income group, and bottom 20% income group. Results: The analysis revealed that 2,158 and 6,667 nurses were needed to provide home visiting health service for the bottom 10% and 20% income groups, respectively. It was estimated that for the vulnerable social group, 10,336 nurses were needed to provide home visiting health service, implying that the need-based demand for nurses is well over 5 times the number currently employed. Conclusion: The results indicate that the number of currently employed nurses is insufficient for the health management of vulnerable social groups. The government should consider active employment policies to encourage nurses to apply for home visiting health service.
Purpose: The purpose of this study is to examine the status of care-giving for the demented elderly and to find out the need of community in-house care services-day care services, short-term care services, home help services, and home care services. Method: It analyzed the data of 186 old people having dementia, and caregivers. Data were collected for five days, in September 2002. Results: The caregivers were mostly women and the burden for the care giving was high (87.5%). They used community care services, that is, day care services (26.5%), home care services (21.6%), home help services 00.8%), short-term care services (6.2%). Caregivers' age and education level were significant factors in the demand for day care services. Caregivers' education level was a statistically significant factor in the demand for short-term care services and home help services. Caregivers' age and education level were significant factors in the demand for home care services. Conclusions: It is necessary to expand the financial aid for the active implementation of daytime protection for dementia-patients under medical treatment at home and to promote patients' recovery. It is necessary to enhance home help services and home care services, and to establish many day care centers and short term care centers. Through this, it will prevent caregivers from becoming burnt out due to the burden of care giving.
The purposes of this study were to identify the needs for ubiquitous home services in residential environment of elderly single or elderly couple households living without children and also to analyze the differences of the needs according to their demographic and housing characteristics. For this study, a literature review and field works on ubiquitous home services for older people were performed. Also, 1 to 1 interview by using the questionnaire which was developed by the researchers in this study was conducted and 270 elderly residents in Seoul and Gyeonggi-Do were responded. Seventy-one ubiquitous service items which were adopted to home electronic appliances and furniture for older people were developed for 1 to 1 interview questionnaire. The major findings of the study were as follows: the elderly residents expressed highest need for ubiquitous home service items related to safety and health issues. Among ubiquitous service items applied to gas stove, vacuum cleaner, TV, telephone, sofa and toilet, the items related to safety and health aspects were most needed. And residents' income level and health status were the two major variables to show group differences in the need of ubiquitous home services. In other words, the elderly residents who were high income and frail tended to have the highest demand for ubiquitous home services adopted to home electronic appliances and furniture.
Background: Supplier induced demand (SID) indicates the case when doctors increase the demand of the patients, following their (physicians') own best interests rather than patients'. This may occur when asymmetry of information exists between suppliers and consumers. This study aims to confirm whether SID exists in the Korean setting, particularly by dividing SID into both 'induced demand effect' and 'availability effect.' Methods: Induced demand effect and availability effect are differentiated following Carlsen & Grytten's theoretical frame which divides doctor density regions into high and low ones. Results: Positive correlation between doctors' density and utilization of their services was found, which could be interpreted as 'availability effect.' Conclusion: The result suggests that additional medical use for additional doctor, particularly in the area of low doctor density, can be interpreted to occur to meet the basic medical need of the people rather than as a result of unnecessary induced demand. It is important to make more medical doctors provided and to distribute them appropriately across the region in such a country like Korea where doctor's density is relatively low.
Purpose: The purpose of this study is to analyze health status of women working in traditional marketplace and their needs for public healthcare services. Methods: A descriptive survey of 500 women working at three traditional marketplaces was conducted. Results: street vendors' health status were much poorer than store merchants'. Furthermore, psychosocial factors like job stress and depression were increased in street venders. Thus, the public healthcare programs required by them included exercise programs (28.2%) and health checkup (26.8%). In addition, 31.2% of the participants reported that they needed visiting nursing care services. The rate of occupational health and safety or employment insurances was as low as 10.8%. Conclusion: Effective interventions including psychosocial factors for women workers at traditional marketplaces need to be developed based on these results. Also, it is recommended that public health care services such as outreach services and visiting nursing care services for women working at traditional marketplaces be provided. Furthermore, institutional provisions such as insurances for protecting these vulnerable groups' health are needed.
Health policies in many countries have come under critical scrutiny in recent years. This is because of increasing national health expenditures. Also many persons in health sector have been the perception that resources allocated to health services are not always deployed in an optimal fashion. And they believe that the scope of resources in health services is limited, there is need to search for ways of using existing resources more efficiently. A further concern has been the desire to ensure access to healthcare of various groups on an equitable basis. In some European countries this has been linked to a wish to enhance patient choice and to make service providers more responsive to consumers, while Korea integrated health insurance funds into single fund in 2000. Many European countries are under considerable pressure to review and restructure their health care systems. There are several reasons of pressure to reform. There are demographic changes, pattern of disease change, advances in medical sciences will also give rise to new demands within the health services, public expectations of health services are rising as those who use services demand higher standards of care. These circumstances require the change of health care delivery system based on hierarchical regionalism, which was basis of health care delivery since 1920s. Korea is also under similarly pressure to restructure our own health care systems. We will have good learning from OECD experiences. In this paper we reviewed and compared among OECD countries' various experiences.
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