• Journal of Society of Preventive Korean Medicine
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• v.6 no.1
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• pp.1-14
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• 2002

The proportion and role of public sector in health care industry is very small in Korea. Asymmetric distribution of health care resources is one of the major health care concerns. This issue is so important that it raises a question of accessibility, availability, continuity of care and equity of rural area people's health care utilization. To solve these problems and to satisfy the basic demand of oriental medical service in rural areas, the oriental public health doctors were placed in rural health centers since 1998. The main objectives of this study are twofold: to measure the cognition and attitude of health center directors on the strategies for utilizing oriental public health doctors and to provide basic data for improving the health manpower management program. Data have been collected by way of the self-administrative questionnaires. Developing the questionnaire, the literature review on the previous studies and delphi method were carried out. The response rate was 38.7%. The results of this study are summarized as follows; 1. community people respond positively on the oriental medical service activity in health center. 2. In regard to workloads of oriental public health doctor, 'appropriate' was 81.1% and 'burdensome' was 18.2%, respectively. 3. The 94.0% of respondents thought that the oriental medical service will be continued. 4. To activate oriental medical service in health center, the sufficient budget and provision of aid workers is a necessity. 5. The 75.5% of health center directors respond positively on the allocation of oriental public health doctor to health sub-centers. 6. Health center directors agreed that oriental public health doctor should perform the clinical service as well as prevention and health promotion activity. These results recommend that oriental medical service in health center should be continued gradually, and oriental public health doctors working at health center perform their work efficiently. Undoubtedly, their activity should be more focused on health promotion and disease prevention than daily patient care. For achieving this objective, more support of governmental policy is essential for utilizing oriental public health doctor and better health of the rural area community people.

• Health Policy and Management
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• v.16 no.4
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• pp.48-67
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• 2006

The aim of the study was to examine levels of satisfaction with health care in North Korea and to identify factors associated with it using a convenience sample of North Korean refugees in China. Data from the 2004 Survey of Health Seeking Behavior of North Korean Households conducted by the Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health were used. The study subjects were 273 North Korean refugees whose length of stay in China was less than 3 months. Factor analysis was used to extract factor dimensions from the 12 satisfaction items. Bivariate (t test and ANOVA) and multiple regression analyses were used in examining factors associated with satisfaction with health care use in North Korea Overall, satisfaction level was low ($2.36{\pm}0.36$, score range: 1-5). Of the three-factor dimensions, physician skills scored the highest $(2.93{\pm}0.36)$, followed by drug availability $(2.51{\pm}0.07)$ and general cleanliness $(1.66{\pm}0.55)$. In the multiple regression analysis, having a usual source of care was significantly associated with patient satisfaction. Respondents who identified primary care (section) doctors as their usual source of care tended to be less satisfied than those with the city or county hospital as their usual source of care. County residents tended to report a lower degree of satisfaction with general cleanliness than city residents. Among socioeconomic characteristics, the number of household assets positively predicted satisfaction with drug availability. North Korean residents appear to be dissatisfied with their medical care. It may reflect some inadequacies in the North's universal health care system to meet the healthcare needs of its people.

• Health Policy and Management
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• v.26 no.2
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• pp.115-124
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• 2016

Background: This study aims at making a survey on health care service providers' cultural competence and making an appraisal of Chinese medical tourists on service quality, health care service providers' cultural competence, perceived value, and satisfaction. Methods: The data was collected from August until November, 2014 and 150 health care service providers and 65 Chinese medical tourists from 12 medical institutions in Daegu were enrolled in analysis. Results: The results showed that health care service provider's knowledge on Chinese culture was very low with 33.5% of correct answer. Health care service providers were found to get 3.82 point on a 5 point-scale in cultural perception, 3.53 points in cultural sensitivity, and 2.85 points in cultural skills. Chinese medical tourists were analyzed to give 4.08 points on a 5-point scale to satisfaction on health care service, followed by 4.01 points to health care service quality, 4.00 points to perceived value of health care service, and last 3.85 points to a health care service providers' cultural skills. However, there was a difference in points in cultural skills between health care service providers and Chinese medical tourists. Chinese medical tourists' satisfaction with health care service in Daegu was found to be comparatively high, but in relation to satisfaction with communication, it was found to be relatively low. Conclusion: Through this research, health care service providers' knowledge level of Chinese culture and cultural skills were low while they seemed to take a half-hearted attitude towards educational experience for building up cultural competence and foreign patient service response.

• The Journal of Korean Society for School & Community Health Education
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• v.12 no.2
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• pp.113-127
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• 2011

Background: University health services have provided comprehensive medical care, counseling, health promotion, and public health services to their students and several other local institutions. To their faculty and staff, university health care centers have served occupational health services and employee assistant program. Purpose: We performed this study to review the health promotion services on two kinds of health care center with different style of university formate. Methods: We tried to collect the data by literature review and interview with executive and provider at health care center in University of California at Berkeley and San Jose State University. Results: Our results were as followed. First, students could use the medical services just as they would their regular doctor's office and urgent care center. Second, the health promotion unit offered programs and services for keeping students healthy and safe, including many opportunities for students to get involved in shaping the public health of the campus. Third, the health promotion recommendation offered from ACHA was useful guideline to improve health status of their member in university campus. Finally, the student satisfaction surveys were used for evaluation and quality improvement. Conclusions: The systematic approach to improve health status of students, faculty and staff can use to maintain a state of optimum health among the diverse student community in support of academic excellence. Coupled with health promotion and public health programs, university health service have to reach all segments of the healthy campus community. To achieve study goals in university, the health care center contributes to promote accountability and responsibility for the health and well being of the members in their campus.

• Health Policy and Management
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• v.26 no.4
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• pp.265-270
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• 2016

Public health system for more prevention-oriented health promotion rather than hospital-based curative service, focusing population rather than individual, and comprehensive health management in the local community strongly needs to be constructed to solve major issues on efficiencies and equity problems which Korean healthcare system is facing nowadays. Public health promotes and protects the health of people and the communities where they live, learn, work, and play. Medical care tries to cure those who have diseases, but public health tries not to become ill and not to be injured. Debates on how we build or rebuild public health system, which is contrasted with medical care system, are needed in Korea, focusing how needs for healthy community and right to health are fulfilled. Public health specialists for practising population health at local community level should be systematically recruited, the function of public health centers should be strengthened, and new government organization should be established for place-based health management.

• 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.

• Research in Community and Public Health Nursing
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• v.15 no.4
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• pp.551-565
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• 2004

Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

• Journal of agricultural medicine and community health
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• v.43 no.2
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• pp.74-84
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• 2018

Objectives: The purpose of this study is to compare the perceptions of the rural healthcare service improvement project' performance and reorganization of public health centers between project staffs and local residents. Methods: Data collection from this study was performed in 141 project areas using structured questionnaires. Data analysis was used in SPSS 22.0 version. Results: The public health center staffs were more positive about the items for improving health facilities than the local residents. Residents in the Si area generally perceived performance as more positive than residents in the Gun area, while public health center staffs in the Gun area perceived performance as more positive than public health center staffs in the Si area. Local residents expressed negative opinions about the reduction in the number of branches of public health clinics and health medical clinics. Conclusions: In conclusion, careful improvement projects for rural health care and the establishment of health care systems will be necessary, reflecting the opinions of local residents, along with a variety of regional characteristics.

• Health Policy and Management
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• v.24 no.3
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• pp.283-290
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• 2014

Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

• Journal of agricultural medicine and community health
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• v.47 no.1
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• pp.1-13
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• 2022

Objectives: This study aimed to establish a linkage model involving regional responsible medical institutions after analyzing the existing conditions and deriving problems through qualitative analysis within the community care system. Methods: A total of 14 participants of this study were selected through the snowball sampling method, including 7 community care service providers and 7 service users. As for the research data, primary data were collected through interviews, and as a result of analyzing according to Aday&Anderson' model, a total of 5 catergories, 8 topics, and 22 sub theme were derived. Results: The problem derived from the interview is that division services are provided for each institution due to the absence of a key central institution of community care system, and users' commercial institutions is unclear. The second is the inconsistency between the needs and supply for community care, resulting in a possibility of delay in returning to the community after discharge. Based on these problems, it is necessary to unify it as an community care window of the Dong-community center. In addition, there is a need for public health centers to play an active role, and to establish a public-private joint system with the Health and Living Support Center to establish a model that can play a certain role. Conclusions: Therefore, based on the results of this study, it can be used as basic data when constructing community care model and applying it as an expanded model in the future.