The objective of this study was to explore the elements and effects of integrated care interventions for the elderly, and to describe the roles of social workers on the multidisciplinary teams. A rapid systematic review was conducted through a database-based search and a manual search. The main findings are as follows: First, Key elements of integrated care for the elderly were case management, individual multidisciplinary care plan, service characteristics, centrality of client needs, patient education, and self-management. Second, In terms of care experience and health of the elderly, and economic analysis, although the results were mixed, there were some positive effects on program participants compared to the control groups. Third, social workers have been found to serve as case managers, care managers, care coordinators, and direct service providers. Based on these results, educational and policy implications were suggested.
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.
Journal of Korean Academic Society of Home Health Care Nursing
/
v.31
no.1
/
pp.66-76
/
2024
Purpose: This study aimed to develop and evaluate an integrated management program to enhance self-efficacy, compliance with sick-role behaviors, symptom management, and biomarker indication in hemodialysis patients. Methods: The integrated management program was developed through a systematic review of literature, analysis of relevant online data, and expert validation. It comprised 480 min of video-based education delivered eight times over four weeks, supplemented by weekly phone consultations and text message support from a nurse. To evaluate the program's effectiveness, it was administered to 44 patients with hemodialysis in a single group in a pre-post test experimental study. Changes in self-efficacy, sick-role behavior compliance, dialysis symptom index, and biomarkers were assessed. Results: The program yielded statistically significant improvements in self-efficacy (t=-7.13, p<.001), sick-role behavioral compliance (t=-7.35, p<.001), dialysis symptom index (t=4.32, p<.001), and blood urea nitrogen levels (t=2.55, p=.014) among the participants. Conclusion: The integrated management program is an effective intervention for improving hemodialysis patients' self-efficacy, compliance with sick-role behaviors, and experience of symptoms. Additionally, it is considered an intervention with high clinical applicability and efficiency through video reproducibility.
Su-Jin Lee;Jong-Yeon Kim;Jae-Wook Kang;Hye-Jin Lee
Journal of agricultural medicine and community health
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v.48
no.4
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pp.262-274
/
2023
Objectives: This study examined the evaluation and potential improvements of 'Integrated Healthcare and Social Welfare service model' based on the experiences of practitioners from institutions participating in the 'Dalgubeol Health Doctor Services' and the service recipients. Methods: Qualitative research was conducted from September to November 2022 in this study, focusing on 4 providers from the dedicated Dalgubeol Health Doctor Services Team, 5 contact partners from affiliated organizations, and 6 service beneficiaries. The data gathered underwent thematic analysis. Results: The evaluation indicated that Dalgubeol Health Doctor Services has proven to be effective in addressing the complex needs of vulnerable populations. By providing integrated services through quick and simple beneficiary selection and resource linkage, it has contributed to the resolution of complex demands, recovery of positive attitudes towards life, and improvement in quality of life for users who have fear the use of medical and welfare services. Dalgubeol Health Doctor Services has established an integrated health care system involving not only public but also private organizations, from the referral agency to the service provider. Centered around Daegu Medical Center and involving five tertiary hospitals, it has established a model that supports treatment appropriate to the severity of the patient, from mild to severe. Conclusions: These findings indicate an enhancement in health equity, achieved through the active identification and subsequent health and welfare issue resolution of individuals marginalized from medical benefits.
Journal of agricultural medicine and community health
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v.49
no.2
/
pp.132-145
/
2024
Objectives: This study compares cases of Dalgubeol Health Care Project, 301 Network Project, and 3 for 1 Project based on program logic models to derive measures for promoting integrated healthcare and welfare services centered around medical institutions. Methods: From January to December 2021, information on the implementation systems and performance of each institution was collected. Data sources included prior academic research, project reports, operational guidelines, official press releases, media articles, and written surveys from project managers. A program logic model analysis framework was applied, structuring the information based on four elements: situation, input, activity, and output. Results: All three projects aimed to address the fragmentation of health and welfare services and medical blind spots. Despite similar multidisciplinary team compositions, differences existed in specific fields, recruitment scale, and employment types. Variations in funding sources led to differences in community collaboration, support methods, and future directions. There were discrepancies in the number of beneficiaries and medical treatments, with different results observed when comparing the actual number of people to input manpower and project cost per beneficiary. Conclusions: To design an integrated health and welfare service provision system centered on medical institutions, securing a stable funding mechanism and establishing an appropriate target population and service delivery system are crucial. Additionally, installing a dedicated department within the medical institution to link activities across various sectors, rather than outsourcing, is necessary. Ensuring appropriate recruitment and stable employment systems is needed. A comprehensive provision system offering services from mild to severe cases through public-private cooperation is suggested.
Cho, Sung-Hyun;Song, Kyung Ja;Park, Ihn Sook;Kim, Yeon Hee;Kim, Mi Soon;Gong, Da Hyun;You, Sun Ju;Ju, Young-Su
Journal of Korean Academy of Nursing Administration
/
v.23
no.2
/
pp.211-222
/
2017
Purpose: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. Methods: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. Results: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. Conclusion: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.
Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.
Integrated health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Health care is one of the most concerned fields in convergence environments. Many studies on the development and application related with health care industry in recent years has been actively. Therefore, in this paper, we described current integrated medical system trends and future works.
The principal objective of this study was to assess the demands of the development program of silver health care professionals for elderly individuals residing in the Northern Gyeonggi-do area. To this end, a survey was conducted to investigate college students and employees related with elderly individuals in the area regarding their recognition, interest, and involvement in the labor training program. In the case of college students, the health education they had received was only 1 to 2 hours, from a school lecture(35%). The content of health education they desired was exercise(34%) and stress management skills(28%). The sources of health information they received included mass media(77%) and the internet(12%), and they trusted the information they received from health professionals(45%), and the mass media(34%). In the case of health professionals who were working at silver care facilities, the sources of health information to which they had access were mass media(51%), internet(14%), reliable health professionals(56%), mass media(22%), and books related to health (18%). The principal issues they reported as being relevant to the elderly were dementia(39%), hypertension(14%), arthritis (11%), and they reported that the most important personnel for elderly in the future would be care managers(44%), and care helpers(21%). 88% of subjects believed that there was a need for a silver welfare integrated information system. 43% of subjects used the internet, 77% of them required in-service training programs for the welfare of the elderly. Via this developmental program of silver health care professionals, a variety of new job opportunities can be provided in the future, and a program related to the silver service industry must be established as soon as possible.
Using a Consensus Qualitative Research approach, this study aimed to identify the ageism and explore age-integration as a solution of age discrimination that occurs during the delivery of medical services by nine healthcare professionals who have experience in treating elderly patients. There were two-sided confession has shown by health care professionals about the Ageism. They reported that they don't discriminate by age. However, They also appealed an inconvenience due to the elderly. There were real Ageism in the Healthcare Professional site as a way of Unsuitable care, elderly alienation and dependence on caregivers, polarization of medical service and double discrimination against poor elderly. They found it difficult to offer age integrated health care as a means to mitigate or solve. However they have sought to break barriers to communication, provided a comfortable environment not only for senior citizens but also for all others, and have diversified institutional and service standards. To ensure the healthy life and proper medical service of the rapidly increasing elderly patients, we proposed to do critical review of the factors in the Korean medical system that accelerate the Ageism, reorganization of the health care system for the poor elderly, including the curriculum associated with age-integrating within the health care professional education system, raising the Geriatric Medical Service and the relating professionals and improvements in perception of the health care domains for the elderly and older adults.
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