• Title/Summary/Keyword: Preventive health services

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Reimbursement for Preventive Health Services: The U.S. Experience

  • Davis, Karen
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.1 s.25
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    • pp.1-7
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    • 1989
  • This paper examines the failure to promote adequate preventive health care in the U.S. It focuses specifically on the preventive health services of screening, counseling, and immunization. It explores evidence on their effectiveness, as well as coverage under current private and public health insurance plans. It concludes with a proposal to expand health insurance coverage for preventive services and to reimburse physicians directly for preventive health services provided to patients.

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A Study on the Health Services Provision of Community Health Practitioners (보건진료원의 보건의료서비스 공급에 관한 관련요인분석)

  • 김영임
    • Journal of Korean Academy of Nursing
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    • v.18 no.2
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    • pp.153-161
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    • 1988
  • The purpose of this study was to analyze the level of the services provision of community health practitioners (CHP) and to find out the influence factors on the services provision of CHP. In this study the dependent variables were the level of community health services(CHS), maternal and child health services(MCH), family planning services(FPS), primary care services(PCS) and the ratios of preventive health services(PHS). And independent variables were predisposing, community demographic and task factors. For this analysis, atepwise regression was used. Data collected for the study on reorganization of health centers organization in 1985 was partly used. The findings of this study can be summarized as follows : First, total variance of independent variables for CHS, MCH, FPS, PCS and PHS are shown 62.5 percent, 58.3 percent, 41.8 percent, 17 percent and 61.9 percent respectively. Second, the most important variables which explain CHS, MCH, FPS, PCS and PHS was ratios of household contacted ($R^2$=0.289), marital status ($R^2$=0.177), marital status($R^2$=0.167), ratios of household contacted($R^2$=0.119) and management of preventive health services($R^2$==0.203) respectively. The independent varivbles used in this analysis presented that the explnining for the provision of preventive health service are more influenced than primary care services. In summary this analysis suggests that the level of preventive health services provision of CHP is low and the provision of primary care services compared with preventive health services are occurred independentely. In the future, the strategies for active preventive services by CHP must to be strengthened.

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Socioeconomic Inequalities in Preventive Services among the Elderly: Results from Medical Checkup, Cancer Check, and BP Check (노년기 예방검진에서 사회경제적 불평등)

  • Chun, Hee-Ran;Kim, Il-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.5
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    • pp.404-410
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    • 2007
  • Objectives: Due to the assumptions of homogeneity as well as challenges in the socioeconomic position of the elderly, they have been relatively neglected in studies of health inequalities. Therefore, this study was conducted to investigate the social inequalities in preventive services among elderly men and women. Methods: Data were obtained from a nationally representative sample of 342 men and 525 women aged 65 and over collected during the 2001 National Health and Nutrition Examination Survey. Age adjusted proportions and logistic regression were used to identify the social patterning of preventive services among elderly Koreans using various social position indicators. Results: The findings of this study generally supported the presence of social gradients in preventive services among the Korean elderly. The likelihood of using the service becomes progressively higher with social position. Educational level, income, and self-rated living status were significantly associated with increased medical checkups and cancer checks. In addition, logistic regression detected educational inequalities only among older women receiving BP checks. After being stratified based on health status and chronic disease status, social disparities still existed when educational level and self-rated living status were considered. Among unhealthy individuals, place of residence was observed as a barrier to medical checkups. Conclusions: This study demonstrated strong and consistent associations between socioeconomic position and preventive services among the elderly in Korea. The results indicate that public health strategies should be developed to reduce the barriers to preventive services encountered by the elderly.

Prevention in the United States Affordable Care Act

  • Preston, Charles M.;Alexander, Miriam
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.6
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    • pp.455-458
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    • 2010
  • The Affordable Care Act (ACA) was signed into law on March 23, 2010 and will fundamentally alter health care in the United States for years to come. The US is currently one of the only industrialized countries without universal health insurance. The new law expands existing public insurance for the poor. It also provides financial credits to low income individuals and some small businesses to purchase health insurance. By government estimates, the law will bring insurance to 30 million people. The law also provides for a significant new investment in prevention and wellness. It appropriates an unprecedented $15 billion in a prevention and public health fund, to be disbursed over 10 years, as well as creates a national prevention council to oversee the government's prevention efforts. This paper discusses 3 major prevention provisions in the legislation: 1) the waiving of cost-sharing for clinical preventive services, 2) new funding for community preventive services, and 3) new funding for workplace wellness programs. The paper examines the scientific evidence behind these provisions as well as provides examples of some model programs. Taken together, these provisions represent a significant advancement for prevention in the US health care system, including a shift towards healthier environments. However, in this turbulent economic and political environment, there is a real threat that much of the law, including the prevention provisions, will not receive adequate funding.

Customer's Intention to Use Hospital-based Health Promotion Services (병원건강증진서비스에 대한 의료소비자의 이용의도)

  • Hahm, Myung-Il;Kang, Myung-Geun;Park, Choon-Sun;Cho, Woo-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.2
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    • pp.108-116
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    • 2003
  • Objective : To determine the relationships between customer's attitude, the subjective norm and the intention to use hospital-based health promotion services. Methods : This study was based on the theory of reasoned action, suggested by Fishbein and Ajzen. The subjects of this study were 501 residents of Seoul, Bun-dang, Il-san and Pyung-chon city, under 65 years, who were stratified by sex and age. A covariance structural analysis was used to identify the structural relationships between attitude towards health promotion programs or services, their subjective norm and their intention to use the aforementioned services. Results : The subjective norm for using the health promotion programs or services provided by hospitals was a significant predictor of the intention to use, but the attitude towards the services was not significant Conclusions : Our results suggest that a customer's reference group affects their use of the hospital-based health promotion services. Because the subjects of this study were restricted to specific urban areas, there are limitations to generalizing the study results. Despite the limitations of these results, they can serve as baseline information for the understanding of consumers behavior toward hospital-based health promotion services.

Research and Development of Urban Health Infrastructure for Home Health Care for the Elderly (도시의 노인보건방문서비스를 위한 자원 및 모델 개발에 관한 연구)

  • Kang, Pock-Soo;Hwang, In-Soo;Kim, Chang-Yoon;Kim, Seok-Beom;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
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    • v.21 no.1
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    • pp.47-60
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    • 1996
  • Home health care is one of the important components of health care services. Today, the need and demand for the home health care is increasing. To assess the effects of home visit health services by public health nurses in health center on the stat of health, use of medical services and quality of life by elderly people living at home, a randomized controlled trial was implemented for 65 years or more old people randomly allocated to intervention(93) and control(118) group. Intervention group received 2 visits a month over 6 months. Control group received no home visits. The data was collected in a one-year follow-up survey conducted at Kyongju before and after the intervention which composed of health risk assessment, risk factor education and health related behavior counseling. The prevalence rate of chronic illness was more decreased in intervention group than control group after intervention. The intervention group visited medical facilities less frequently than control group. And the home visit health services encouraged the elderly to practice regular exercise. After the intervention, the score of ADL(activities of daily living), LSI(life satisfaction index) and SSI(social support index) in intervention group were more increased than control group. And the increase of scores was more prominent in 70 years or more old people, female, non-smoker and non-chronic illed elderly rather than others. In conclusion, the regular home visit health services provided by public health nurses were beneficial for the elderly in terms of health promotion and quality of life.

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Associations of Handgrip Strength and Handgrip Strength Asymmetry With Depression in the Elderly in Korea: A Cross-sectional Study

  • Hurh, Kyungduk;Park, Yoonsik;Kim, Gyu Ri;Jang, Sung-In;Park, Eun-Cheol
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.1
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    • pp.63-72
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    • 2021
  • Objectives: Recent studies have suggested that assessing handgrip strength (HGS) asymmetry together with HGS may be helpful for evaluating problems in geriatric patients. This study aimed to identify whether HGS asymmetry, weakness, or both were associated with depression in Korean older adults. Methods: This study included 4274 subjects from the sixth and seventh Korea National Health and Nutrition Examination Survey. Depression was measured using the Patient Health Questionnaire-9. The maximum HGS of the dominant hand was used as a representative value. HGS symmetry was categorized by the ratio of the HGS of the dominant hand to that of non-dominant hand. The odds ratio (OR) for depression was calculated according to the HGS and its symmetry. Results: In total, 240 (12.5%) men and 534 (22.7%) women had depression. HGS or HGS asymmetry showed no statistically significant associations with depression in elderly men. Elevated odds of depression were observed in elderly women with low HGS (OR, 1.93; 95% confidence interval [CI], 1.33 to 2.81) or prominent HGS asymmetry (OR, 1.46; 95% CI, 1.02 to 2.08). There was a positive additive interaction between asymmetric HGS and weakness, as women with low and prominently asymmetric HGS showed higher odds of depression (OR, 3.77; 95% CI, 2.16 to 6.59) than women with high and symmetric HGS. Conclusions: Depression in elderly Korean women was associated with both low and asymmetric HGS. Our findings support the potential value of HGS asymmetry as an indicator of HGS.