• 제목/요약/키워드: Primary medical care

검색결과 640건 처리시간 0.027초

치매환자 부양자부담과 생활권 내 소규모 주·야간 돌봄 서비스 모델 (Caregiver Burden of Patients with Dementia and Day Care Center of Small Size Model within a Zone of Life)

  • 나승권;박은주
    • 한국정보전자통신기술학회논문지
    • /
    • 제9권4호
    • /
    • pp.428-438
    • /
    • 2016
  • 본 연구의 목적은 치매환자 부양자의 부담을 감소시키기 위해 장기요양보험 제도의 틀 안에서 새로운 서비스 개발을 제시하는 것이다. 분석 자료로 선행연구와 2012-2013년에 걸쳐 조사된 Caregivers of Alzheimer's Disease Research(CARE study)를 사용하여 부양자의 특성과 부담을 조사하였다. 치매환자의 주부양자 부담은 신체적, 심리적, 경제적 측면뿐만 아니라 다양한 측면에서 어려움을 겪고 있으며 연령, 경제력, 건강상태, 사회적지지 등 여러 요인이 부양부담에 영향을 미치고 있었다. 또한 부양자가 우울증을 겪을 위험도 높게 나왔다. 이에 부양자에 대한 제도적 지원이 필요한 시점에서 2008년부터 시행된 노인장기요양보험 제도를 활용하여 본 연구에서 추가적인 서비스를 제시하였다. 현 제도의 재가서비스 확장 모델로 소규모 주 야간보호서비스(가칭)를 신설하는 것으로 9인 이내의 규모로 주거지에서 5분 이내 거리에 개설을 하고 치매환자에만 국한시켜 질환에 대한 전문성을 높이고 서비스의 질을 향상시켜 기존의 주 야간보호서비스와 소규모 노인요양공동생활가정과 차별화하는 것이다.

초등학교 어린이의 허약상태 및 성장부진에 대(對)한 보고(報告) (The statistical study of Weakness and the Delayed Growth on primary school children)

  • 장보형;권미원;왕향란
    • 대한한방소아과학회지
    • /
    • 제19권2호
    • /
    • pp.137-152
    • /
    • 2005
  • Objective : As the meaning of collective medical examination, the purpose of this study is to investigate distribution of weak children by measurement according to the five group of weakness (Lung, Heart, Pancreas, Liver, Kidney), and the relationship between the five group of weakness and the Growth failure on primary school children. Methods : This study is composed of 1078 children who attend A primary school in ${\bigcirc}{\bigcirc}$ city. They are divided into 6 groups by grade and for the purpose of effective comparison, The five weak symptoms are studied to determine the association with growth stature among children and we standardize the weak children's height into percent according to age. Results: When each weak children controled grade, sex, body-weight, existence or nonexistence of personal history, physical exercise so on, relatively group of weakness for kidney is statistically less then opposite group and the rest of the people statistically have no significant difference. Conclusions: From the above result, it is suggested that the statistical relationship between the weakness for kidney and growth(p<0.001). It looks forward to have contributed to collective medical examination and children's health care by oriental medical treatment.

  • PDF

보건의료 주민참여의 정의와 전략에 대한 연구 (Definition and Strategy of Community Involvement in Health)

  • 김용익
    • 보건행정학회지
    • /
    • 제2권2호
    • /
    • pp.90-111
    • /
    • 1992
  • Community involvement is to be the keystone of primary health care, Unfortunately, efforts to promote it failed in many countries. Author inquired into the reasons why such efforts fail, and the alternative strategies for effectively promoting it in Korean situation today. In doing so, the concept of community involvement is clarified as an amalgamation of two different concepts; one is that of the community development, and the other is that of approaches for overcoming the alienation of the people from the health care process. Stategies of community involvement in Korea so far followed the line of the community development, e.g. village health worker. It loses, however, the feasibility as Korea has experinced so cial and economic developpment. The strategies of the second line of thought is now more feasible; empowering the people by providing more information and enhancing comitment to health, improving acceptabilty of community involvemt on the part of the health professionals and the bureaucrats, and building the mechanism of community involvement into the health policy-making process.

  • PDF

국민학교 학생의 시력관리 지식 및 실천과 시력장애에 관한 조사연구 -3, 4, 5, 6학년을 중심으로- (A Study on the Visual Impairment State and Knowledge and Practice about Visual Impairment Protective Care of the Primary School Students in Chonbuk Area)

  • 정영숙
    • 한국학교보건학회지
    • /
    • 제6권1호
    • /
    • pp.58-68
    • /
    • 1993
  • This study was designed to grasp the knowledge and practice the level about visual impairment protective care of the primary school students and also analyse the state of visual impairment. The subjects of this study ware 347 students composed of 456 boys and 391 girls in primary school students. The data were collected by questionaire developed for the purpose of this study which has been made through studying references. These were carried out from the 10th to 30th of June 1992. Analysis of the data was done utilizing SPSS for percentage, mean, S.D., T-test., ANOVA and Pearson's Correlation Coefficient. The major results obtained from this study were as follows: 1. The level of the knowledge about visual impairment protective care was in intermediate range (mean on 20 point scale of 12.34, with O=definitely no), but low in aspects of preventive care for overwork of eye (mean on 5 point scale of 2.67). 2. The level of the practice about visual impairment protective care was intermediate range (mean on 20 point scale of 12.34, with O=definitely no), but low in aspects of preventive care for overwork of eye (mean on 5 point scale of 2.58). 3. Significant variables influencing knowledge of visual impairment protective care were sex (p<0.01) and grade (p<0.001). 4. Significant variables influencing practice of visual impairment protective care was living area (p<0.01). 5. Correlation between knowledge and practice: Those who have more knowledge score have more practice score (p<0.001). 6. vision impairment state 1) Student with subnormal in 0.9 or less were 26.3% in left eye and 28.4% in right eye. 2) Student with subnormal in 0.6 or less were 11.9% in left eye and 10.9% in right eye. 7. Vision impairment programs 1) Males are slightly higher in the degree of visual impairment than females. 2) Visual impairment were increased in accordance with the increase of grade. 3) Urban students are higher in the degree of visual impairment than rural students, but these seem to have no statistical meaning.

  • PDF

미국 전문간호사(NP)의 역할과 교육과정에 관한 고찰 (Nurse Practitioner Roles and Curriculums in the United States)

  • 이선옥
    • 한국간호교육학회지
    • /
    • 제5권1호
    • /
    • pp.97-105
    • /
    • 1999
  • Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

  • PDF

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
    • /
    • 제7권1호
    • /
    • pp.29-94
    • /
    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

  • PDF

태아의 안녕과 안전한 출산 : 조산사의 역할 (Midwife's role for mother and infant wellbeing)

  • 이경혜
    • 부모자녀건강학회지
    • /
    • 제3권2호
    • /
    • pp.67-80
    • /
    • 2000
  • This study was described as midwife's role and obstacle of midwife's role expansion. Midwife as primary medical personal who practices for a mother and infant health care and promotion of mother infant interaction. As the trend of increasing natural childbirth, midwifery has to provide childbearing care those who want delivery in a midwifery center. This study conducted to survey for 44 midwives who work at the midwifery center. The results of the study as fellows. 1. Most of the midwives role was care of pregnancy, delivery, postpartum women and babies. Another role was conducted educational classes childbirth, breast feeding, contraception and sexual education. 2. Some midwives role perform breech, vaccum delivery, episiotomy and suture, pitocin induction and augmentation, ultrasonogram, giving medication, anesthesia, collecting specimen from Pap smear and vaginal discharge. Midwife perform these roles without medical law support. 3. Most of the obstacles of the midwife role was the medical law limitation. Midwives want revise medical law to perform simple treatment for childbearing women and babies. 4. Half of the midwives refer cases to medical doctor in case of complication of women and newborns. 5. Current frequency of home birth rate is slightly higher than before and me cases like to have delivery under water. Finally, midwife and midwifery have to prepare to meet childbearing woman, baby and family's need. For activation and expansion of midwife's role, every midwife has to be aware of medical law accurately and they must know what practice they can do and what practice they can not do.

  • PDF

Clinico-pathological Features of Gynecological Malignancies in a Tertiary Care Hospital in Eastern India: Importance of Strengthening Primary Health Care in Prevention and Early Detection

  • Sarkar, Madhutandra;Konar, Hiralal;Raut, Deepak
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권6호
    • /
    • pp.3541-3547
    • /
    • 2013
  • Background: This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India. Materials and Methods: In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. Results: The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage III, followed by stage II (40.7%) malignancy. Conclusions: This study highlights that most of the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.

A Comparative Study on Primary Health Care in Republic of Korea and Republic of Uzbekistan

  • Dronina, Yuliya;Moon, Jiyoung;Nam, Eun Woo
    • 보건행정학회지
    • /
    • 제27권3호
    • /
    • pp.256-266
    • /
    • 2017
  • Background: Primary health care (PHC) plays a major role to ensure the basic right and equal distribution of the essential health care services. This study presents comparative analyses of PHC in Korea and Uzbekistan, discusses the existing scenario and the challenges, and provides recommendations. Methods: This study reviewed secondary data from Korea's National Statistical Information Service and the State Committee of the Republic of Uzbekistan on Statistic, regulatory legislation, research reports, and policy papers by research and international institutions. We focus on comparing input and outcome health data, PHC structure, and health expenditure. Results: Overall health status of the population in Korea is better than in Uzbekistan; both countries achieved more than 95% immunization coverage. The reforms implemented in both countries provide initial health care service delivery. However, there are several challenges such as the distribution of the staff between urban and rural areas and interest of the graduates on specialization rather than working in PHC system. Conclusion: PHC plays an important role in the provision of medical services to the population, addressing both health and social problems; it is the best tool for achieving universal coverage for basic health needs of the population. The community health practitioners in Korea and nurses in Uzbekistan plays main role in universal coverage through providing essential health care services. Continuous reform of the PHC system should be directed to strengthen the capacity of the PHC staff in health promotion knowledge and activities as well as to encourage population to improve their own health.

A study on policy of elders' long term care services: Focusing on problems of insurance system and solutions

  • Quan, Zhi-Xuan
    • 융합경영연구
    • /
    • 제4권3호
    • /
    • pp.7-11
    • /
    • 2016
  • The purpose of this study is to examine the long term care insurance system that has been 9 years and to understand issues arose during settlement of the insurance system in accordance with provision of solutions to increase the quality of elders' long term care service. Also, the study is aiming at providing contribution to both satisfaction of customers and workforces at the field along with achievement of the primary goal that the elders' care service policy was aiming at. To achieve the purpose of the study, authors gathered and analyzed reports and literatures from books published domestically, governmental open data and statistical data related to policy on long term care service insurance for elders to examine current problematic issues of long term care insurance and to explore ways to improve by having case studies of advanced countries. The result of this study shows that there are differences in the way how participants of the programs react to registering to insurance of program for supporting elderly persons' social activities and employment despite Korean government is operating the programs along general guidance for the programs as a standardized guideline.