Objectives: This study evaluated the response in Daegu, Korea to the first wave of the coronavirus disease 2019 (COVID-19) pandemic according to a public health emergency response model. Methods: After an examination of the official data reported by the city of Daegu and the Korea Centers for Disease Control and Prevention, as well as a literature review and advisory meetings, we chose a response model. Daegu's responses were organized into 4 phases and evaluated by applying the response model. Results: In phase 1, efforts were made to block further transmission of the virus through preemptive testing of a religious group. In phase 2, efforts were concentrated on responding to mass infections in high-risk facilities. Phase 3 involved a transition from a high-intensity social distancing campaign to a citizen participation-based quarantine system. The evaluation using the response model revealed insufficient systematic preparation for a medical surge. In addition, an incorporated health-related management system and protection measures for responders were absent. Nevertheless, the city encouraged the participation of private hospitals and developed a severity classification system. Citizens also played active roles in the pandemic response by practicing social distancing. Conclusions: This study employed the response model to evaluate the early response in Daegu to the COVID-19 pandemic and revealed areas in need of improvement or maintenance. Based on the study results, creation of a systematic model is necessary to prepare for and respond to future public health emergencies like the COVID-19 pandemic.
The aim of this study sets out to discover a desirable form of public centers among the alternative ones and make a health center model. Especially, this study attempts; (i) to investigate factors that affect the performance of health centers; (ii) carry out cost-effectiveness analysis (CEA) for the various type of health centers; (iii) identify innovative strategies to increase the use of health center. Cost-effectiveness analysis is used to compare the performance of all the centers. The following is taken to create the index. Wi = Ti x Mi x Eij (Wi: weight for service item I, Ti : time spent for service I, Mi ; number of health personnel involved in service I, Eij : years of schooling for personnel j in providing service I). As a result of these analyses, policy options as follows are recommended; (i) proper manpower, especially public health physician (oriental medical doctor), should be enough to provide health care adequately; (ii) facilities ad equipments in the health center should be provided sufficiently. (iii) the utilization of health centers should be raised by active operation of mobil service, community participation and health education program. Ultimately health centers in public sector are to be fostered for the promotion of health care by enhancing the financial and quality, continuity and efficiency of health services.
The increase of health care expenditures is an important problem in the almost countries. Also, suppression of the health care expenditures is an important problem in the health field of Korea since the national health insurance for total people in 1989. Thus, it is very important to grasp the change of the health care expenditures of family and proportions of the health care expenditures to total expenditures of family, because they are the basis of national health care expenditures in Korea. While the health care expenditures of urban family were increased during 1980-1993 by 12.8% annually, the total expenditures of urban family were increased by 14.8% annually. Consequently, the proportions of health care expenditures to total expenditures were decreased from 5.98% to 4.76%. The proportions of health care expenditure for 3 years to come were predicted to 4.75% in 1994, 4.67% in 1995, and 4.63% in 1996 by the time-series analysis. That is, it was predicted that they would be decreasing slowly. The product elasticity of health care expenditure was less than 1 in the multiple regression analysis. so the health care is normal good rather than superior good. Therefore, it seems that the household economy is able to bear the expense pursuing the improvement of quality of health care by actualizing the medical insurance fee.
A great deal of attention has been paid to the quality of life in citizens due to the increased number of long term life expectancy. reported as effective in the health promotion of the senior citizens. In this study, the principal investigator developed an exercise program for the senior citizens, which could be educated and managed by nursing staff. This kind approach may support the need of exercise program on regular base via the social organization, which may mean the intentional change of life style. The exercise program consisted of exercise, health education, and a direct the population of the senior A regularexercise has been nursing care. A quasi -experimental study was conducted to investigate the effects of excercise program on health of the elderly in senior citizen's center. Independent variable was a 9 weeks exercise program. Dependent variables were: 1) physical health [e.g. physical fitness(cardiopulmonary endurance, back muscle strength, grip strength, muscular tolerance, flexibility and body fat proportion), physiologic parameters(blood pressure, pulse, respiration. and blood glucose), and perceived physical health status; 2) mental health measured by depression score; and 3) cognitive perception of exercise measured by usefulness and self-efficacy. A total of 37 subjects was randomly assigned into either the control group (without the exercise program: n=18) or the intervention group(with the exercise program: n=19). The results of the study analyzed using a SAS, were as follows: 1) In physical fitness of physical health, there was a significant improvement in cardiopulmonary tolerance. back muscle strength. muscular tolerance and flexibility in the intervention group, compared to the control group, while no difference in grip strength and body fat proportion. The exercise program resulted in decreases in blood pressure, pulse, respiration and blood glucose within normal range and improvement of perceived physical health status in the intervention group. 2) There was a slight increase of mental health(depression score) in the intervention group compared to the control group. but without statistical significance. 3) There was a significant improvement in cognitive perception of exercise(e.g. usefulness and self -efficacy) in the intervention group, compared to the control group. It was concluded that the exercise program employed in this study was appropriate for women senior citizens and had a positive effect on health in general.
Background : In this paper patient outcomes research is going to be reviewed and described, to be compared with relevant studies, and to consider the application in Korea. Methods : We compiled and reviewed the articles and materials related to patient outcomes research especially by PORT(Patient Outcomes Research Team) and rearranged them for seeking the main point and comparing with relevant studies. Results : Patient outcomes research emphasizes patient outcomes as well as conventional clinical outcomes. It is prospective study observing effectiveness in real situation instead of efficacy in ideal condition. Patient outcomes research comprises of 6 fields ; literature review and meta-analysis, use of claims data, decision modeling, outcomes assessment, cost of care, dissemination of research findings. SAA(small-area variations analysis), appropriateness study and clinical practice guideline are connected with patient outcomes research. Conclusion : In view of the fact that current medical policy in Korea is shifting its focus from accessibility to the improvement in quality and cost containment, and is stressing patient-based research, patient outcomes research is one direction for which the medicine is accountable and assessable. Considering that the number of patient receiving medical treatment in Korea is higher than the West, patient outcomes research has competitive power as against the West.
This study investigated the German experience in the transition to a unified health care system and suggests the following implications for Korea. First, Germany could have made use of the unification process better if there had been a good road map. Therefore Korea must develop a well prepared road map that considers all possible situations. Second, Germany saw an opportunity for the improvement of the health care system in the early stage of unification but could not take advantage of it because the situation changed dramatically and they had not sufficiently prepared for it. Korea should take into account the opportunity for improvement of the present health care system, such as the roles of public health and traditional medicine. Thirdly, the conditions f North Korea seem to be far worse than those of former East Germany and also worse than even those of other transition countries. Therefore Korea should design a long-term road map taking as many variables into account as possible, including the different rigid way of thinking and the interrelationship among the social sectors. Fourthly, during the German reunification unexpected factors changed the direction of the events. Korea should have a separate plan for the unexpected factors.
This study, based on stages of behavioral change, was aimed at suggesting strategies for the adoption of moderate drinking habits for community-based health education designed to help rural people. An interview survey was conducted during the period from March 4 to April 5, 2002 by sampling 467 rural people living in 6 villages covered by a public healthcare clinic. The results of this study can be summarized as follows; 1. The perceived non-moderate drinkers were less prepared for behavioral change. 2. The heavier drinking habits were ‘drinking alone’, ‘meals accompanied by drinking’ and ‘drinking twice or more at a time’. The agricultural off-season and the custom of brewing liquor at home were negative environmental factors for moderate drinking. 3. The predisposing factors affecting moderate drinking were recognition of health, expectation of the drinking effect, etiquette encouraging overdrinking and control of drinking. The reinforcing factors were stress from ordinary life and perception of being loved. The enabling factor was accessibility to the public healthcare clinic. 4. Rural residents are less motivated to participate in health education for moderate drinking. Based on the above findings, health education strategies for each stage can be suggested as follows: 1) Pre-contemplation stage: improvement of perception, motivation, sharing of experiences, and reawakening. 2) Contemplation/preparation stag e: measurement of value, departure from the inertia against a change, formation of a habit, and reinforcement of the behavior. 3) Action/maintenance stage: creation of a social atmosphere, encouragement of participation, change of life style, and improvement of environment.
Background: The Community-Based Participatory Research (CBPR) approach is recognized in the field of health promotion as a way to optimize intervention for promoting health by taking into account specific social, economical, and institutional situations of the community. However, the CBPR approach has not been applied in the field of community-based rehabilitation. Objects: This study was conducted to explore the self-perceived satisfaction of therapists and disabilities on the Short-term Intensive Home-based Rehabilitation (SIHR) program developed using the CBPR approach as well as determine the points that need improvement. Methods: This research was conducted through in-depth interviews. The SIHR program was developed, applied, and evaluated by both the researchers and four therapists on the basis of the CBPR approach. The SIHR program was administered to four disability for 1 hour a day, 2 or 3 times a week, for 8 weeks, and their self-rehabilitation was monitored once a week for 4 weeks. After all intervention periods, in-depth interviews were conducted by using a semi-structured questionnaire for the therapists and disability. Results: The therapists were satisfied with the contents of the SIHR program, such as behavioral change technique and goal-directed training. They were also satisfied with the process of developing the program through a community network. Disabilities were satisfied with the therapists' persuasive and emotionally interactive way of delivering the SIHR program as well as the individually customized rehabilitation training and physical improvement. The short period (8 weeks) of the SIHR program was noted by both therapists and disabilities as the part that needs improvement. Conclusion: The SIHR program developed using the CBPR approach was feasible and satisfying to therapists and disabilities. However, a longer SIHR program should be developed. Community networks could help therapists effectively utilize community resources and thereby provide more rehabilitation program for persons with disability.
Liautaud, Alexandre;Adu, Prince A.;Yassi, Annalee;Zungu, Muzimkhulu;Spiegel, Jerry M.;Rawat, Angeli;Bryce, Elizabeth A.;Engelbrecht, Michelle C.
Safety and Health at Work
/
제9권2호
/
pp.172-179
/
2018
Background: Insufficient training in infection control and occupational health among healthcare workers (HCWs) in countries with high human immunodeficiency virus (HIV) and tuberculosis (TB) burdens requires attention. We examined the effectiveness of a 1-year Certificate Program in Occupational Health and Infection Control conducted in Free State Province, South Africa in an international partnership to empower HCWs to become change agents to promote workplace-based HIV and TB prevention. Methods: Questionnaires assessing reactions to the program and Knowledge, Attitudes, Skills, and Practices were collected pre-, mid-, and postprogram. Individual interviews, group project evaluations, and participant observation were also conducted. Quantitative data were analyzed using Wilcoxon signed-rank test. Qualitative data were thematically coded and analyzed using the Kirkpatrick framework. Results: Participants recruited (n = 32) were mostly female (81%) and nurses (56%). Pre-to-post-program mean scores improved in knowledge (+12%, p = 0.002) and skills/practices (+14%, p = 0.002). Preprogram attitude scores were high but did not change. Participants felt empowered and demonstrated attitudinal improvements regarding HIV, TB, infection control, and occupational health. Successful projects were indeed implemented. However, participants encountered considerable difficulties in trying to sustain improvement, due largely to lack of pre-existing knowledge and experience, combined with inadequate staffing and insufficient management support. Conclusion: Training is essential to strengthen HCWs' occupational health and infection control knowledge, attitudes, skills, and practices, and workplace-based training programs such as this can yield impressive results. However, the considerable mentorship resources required for such programs and the substantial infrastructural supports needed for implementation and sustainability of improvements in settings without pre-existing experience in such endeavors should not be underestimated.
In contemporary society interest in and consumption of beauty treatment are increasing, raising interest in health and beauty. However, beauty-related laws are becoming factors of hindrance of beauty development. Currently the Public Health Control Act plays a basic role in the beauty art business in Korea, However the contents are in discord with international laws and its definition is not clear. Therefore it is causing conflicts of different occupations and job associations which are similar to art business. Especially, because neither definitions nor policies on beauty care devices exist in the Public Health Control Act, beauty care devices using in foreign countries cannot be used in Korea due to classification as medical devices. Under this circumstance, therefore, beauty care device uses by beauty artists violate the law. The government has tried to solve these irrational regulations. Recently, the Small and Medium Business Administration announced 'the improvement plan of small business and young founders site regulation for public economy recovery' in a ministerial meeting on December 28, 2016. Regulations on policy preparation for skincare devices were inclusive in this announcement. It is the question whether the regulations will be executed or not. Even though beauty industrial competitiveness was presented in the 18th Presidential Council on National Competitiveness in 2009, it was not practiced. The proposal bills for beauty law improvement have been put forth several times since 2000 including an improvement plan for regulating beauty care devices. However, so far there have been no improvements. The damage on the regulation classifying beauty devices as medical devices is not only restricted to skincare. This develops beauty devices and the beauty industry which imports and exports beauty devices. When beauty devices are exported, complicated procedures are unavoidable and when beauty devices are imported, irrational problems like reregistration procedures and costs occur. The reason why an improvement plan has not gone into practice is the resistance of the dermatologists' association. Dermatologists tend to stand positively against harming public health by saying that beauty devices used by beauty artists cause people to suffer side effects. In contrast, anyone who has a licence to use beauty devices is able to use them in foreign countries. It is not only infringement of one's right as a beauty artist but also people's right to receive beauty care services. With this reason, Korean's current law under which beauty devices are ruled as medical devices should be revised with accordance to domestic surroundings. Therefore in order to advance and globalize the beauty industry, the support and cooperation of the Korean government and relevant associations is needed to legislate and revise the beauty devices laws. The relevant associations abandon regional self-centeredness and cooperate to define ranges, size and management of beauty devices for safe use. If no collaboration exists, an arbitration agency should be established to solve the problem.
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