• Title/Summary/Keyword: Quality of primary care

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A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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Quality of Life Changes in Patients Admitted to the Hospice Unit (호스피스 병동 입원 환자의 삶의 질 변화)

  • Park, Theresia;Song, Hae-Hiang;Seo, In-Ok;Cho, Young-Yee;Park, Myung-Hee;Heo, Jeong-Hee;Kim, Eun-Kyung;Park, Sun-Ju;Ra, Jeong-Ran
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.18-27
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    • 2000
  • Purpose : This study aims to find out the quality of life of patients admitted to the hospice unit at Kangnam St. Mary's Hospital, at admission and after weeks hospice service and to assess the effects of hospice service on the quality of life of terminal cancer patients. Methods : This study subjects were 100 patients admitted to the hospice unit at Kangnam St. Mary's Hospital, Catholic University between October 1999 and March 2000, and their primary caregivers. Quality of life data were collected using a questionnaire revised by the authors and were analyzed by means of repeated measures ANOVA. Results : 1) Patient's quality of life as perceived by the primary caregiver was significantly improved and the mean score was 3.31, 3.68, 3.56, 3.73, 3.75 at admission and week 1, 2, 3, 4. With the detailed item analysis, the following items were shown to be significantly improved: "clean bodies"(F=6.50, P=0.0001) "pain control"(F=18.01, P=0.0001) constipate"(F=2.96, P=0.0237) "sleep"(F=3.99, P=0.0048) "nausea/vomiting"(F=4.50, P=0.0022) "medical team's comfortable care" (F=3.95, P=0.0051) "family's care"(F=2.76, P=0.0317) "anxiety" (F=3.14, P=0.0177) "comfort"(F=3.63, P=0.0085) "treat with dignity"(F=3.32, P=0.0136). The item of "death is not the end of life rather the beginning" was significantly decreased(F=2.54, P=0.0450). 2) Patient's quality of life as perceived by the patient showed an improvement but statistically insignificant and the mean score was 3.63 and 3.83 at admission and week 1. With the detailed item analysis, the item of "pain control" was shown to be significantly improved(F=9.19, P=0.0251). 3) The quality of score in the last week of life of patient were 3.48, 3.51, 3.44, 3.46, 3.50, respectively, from 5 week prior to 1 week prior to death and these changes were insignificant. Conclusion : The findings of this study showed a positive effect of hospice service on quality of life of the terminal cancer patients admitted to the hospice unit. To improve the quality of life, we need first of all to develop hospice interventions with a particular emphasis on the spiritual aspect of patient. Secondly, measurement instruments need to be developed to collect the quality of life of the hospice patients who become weakened especially in the last weeks of their life and with this effort more representative data of hospice patients may be collected.

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A Repository for Publications on Basic Occupational Health Services and Similar Health Care Innovations

  • Frank J. van Dijk;Suvarna Moti
    • Safety and Health at Work
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    • v.14 no.1
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    • pp.50-58
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    • 2023
  • Background: Occupational health services are not available for more than 80% of the global workforce. This pertains especially to informal workers, workers in agriculture and in small enterprises, and self-employed. Many are working in hazardous conditions. The World Health Organization, the International Labor Organization, the International Commission on Occupational Health, and the World Organization of Family Doctors promote as part of a solution, basic occupational health services (BOHS) integrated in primary or community health care. Quality information on this topic is difficult to find. The objective of this study is to develop an open access bibliography, a repository, referring to publications on BOHS and similar innovations, to support progress and research. Methods: The database design and sustaining literature searches (PubMed, Google Scholar, SciELO) are described. For each publication selected, basic bibliographic data, a brief content description considering copyright restrictions, and a hyperlink are included. Results: Searches resulted in a database containing 189 references to publications on BOHS such as articles in scientific journals, reports, policy documents, and abstracts of lectures. A global perspective is applied in 43 publications, a national or regional perspective is applied in 146 publications. Operational and evaluative research material is still scarce. Examples of references to publications are shown. Conclusion: The repository can inspire pioneers by showing practices in different countries and can be used for reviews and in-depth analyses. Missing publications such as from China, Russia, Japan, Republic of Korea, and Spanish/Portuguese speaking countries, can be added in the future, and translated. Search functions can be developed. International collaboration for the promotion of occupational health coverage for all workers must be intensified.

Quality of Life and Family Burden in Hemopoietic Stem Cell Transplantation Recipients (조혈모세포이식 환자의 삶의 질과 가족 부담감)

  • Bok, Ji-Na;Sohng, Kyeong-Yae;Park, Han-Jong
    • Asian Oncology Nursing
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    • v.5 no.2
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    • pp.136-145
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    • 2005
  • Purpose: To investigate the degree and relationship of the quality of life(QOL) and family burden in hematopoietic stem cell transplantation recipients(HSCTr) at admission and discharge to isolation unit. Method: Data were obtained by interviewing from 60 HSCTr and 50 of their primary caregivers' and were analyzed by SAS program. Result: The degree of quality of life in pre and post HSCTr was significantly lower in the group who had physical discomfort compared with those who had no physical discomfort. The mean score of quality of life in pre HSCTr was significantly lower compared with in post HSCTr. Objective burden of family was higher than subjective one. Conclusion: QOL in HSCTr showed lower in the group of who had medical history, physical discomfort, no hope for cure and more than 5 weeks of length of stay. On the basis of these results, it is necessary to develop nursing intervention and to apply nursing care for improving their quality of life.

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Development of Performance Measures Based on the Nursing Process for Prevention and Management of Pressure Ulcers, Falls and Pain (욕창, 낙상예방 및 통증간호의 간호과정 적용 평가도구 개발)

  • Kim, Keum Soon;Kim, Jin A;Kim, Moon Sook;Kim, Yu Jeong;Kim, Eul Soon;Park, Kwang Ok;Song, Mal Soon;Yi, Young Hee;Lee, In Ok;Jung, Yoen Yi;Choi, Yun Kyoung
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.1
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    • pp.133-147
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    • 2009
  • Purpose: This study was conducted to construct evidence based clinical guidelines and to develop nursing process based performance measures for prevention and management of pressure ulcers, falls and pain. Method: Clinical guidelines were drafted through a comprehensive review of relevant literature, national guidelines and hospital protocols. The proposed guidelines were reviewed by a panel of experts and 90 hospital nurses, and refined on the basis of their suggestions. Nursing process based performance measures were developed based on the clinical guidelines and content validity was examined by surveys from 90 hospital nurses. Results: All items, except timetable for position change and pressure ulcer nursing record, in the guidelines for prevention and management of pressure ulcer were appropriate. Most items, except fall risk assessment tools, were appropriate for the guidelines of fall prevention. All other items, except the purpose of pain management, were appropriate for the guidelines of pain management. Performance measures developed in this study were acceptable as a tool to evaluate quality of nursing care. Conclusion: Nursing process based performance measures provide important indicators to monitor whether necessary nursing care is implemented and can be used as the primary resources to improve quality of nursing services.

A Analysis of Relative Importance of Evaluation Categories for Hospital Food Service by Analytic Hierarchy Process (AHP기법을 이용한 병원 환자식 운영 품질 평가 분야의 중요도 분석)

  • Sohn, Chun-Young;Yang, Il-Sun
    • The Korean Journal of Food And Nutrition
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    • v.23 no.4
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    • pp.470-477
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    • 2010
  • The purposes of this study were to identify the evaluation categories, areas, attributes of the hospital food service and to define the relative importance of the evaluation categories, areas, attributes of the hospital food service using analytic hierarchy process. A survey was conducted from January 8th to 25th in 2007. Questionnaires were mailed to the 310 directors of dietetic departments of hospitals that included 160 primary hospitals, 107 secondary hospitals, and 43 tertiary hospitals. The result of the analytic hierarchy process indicated that relative importance of evaluation category was 0.5259 for food service management and 0.3407 for nutrition care. The food service management consisted of four subcategories, which are equipment standard, sanitation, production, and delivery service. Sanitation(relative importance: 0.2652) was the most important area among the subcategories and it was followed by equipment standard(0.2067), delivery service(0.1864) and production(0.1848). The nutrition care has two subcategories, menu management and meal management. The relative importance of menu management(0.4174) was higher than that of meal management(0.3555). The quality of food service and nutrition care to inpatients can be improved by the evaluation system based on appropriate applications of the developed evaluation indicators for hospital food service systems.

Position Value for Relative Comparison of Healthcare Status of Korea in 2020 (2020년 한국 보건의료의 상대적 위치와 추이: 경제협력개발기구 국가와 비교)

  • Yu Shin Park;Minah Park;Eun-Cheol Park
    • Health Policy and Management
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    • v.33 no.2
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    • pp.203-213
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    • 2023
  • This study examined the trend of healthcare status and compared the status of South Korea and other member of the Organization for Economic Cooperation and Development (OECD) using the OECD health statistics 2022. We used the OECD health statistics from 2022 and a position value for relative comparison (PARC) index to compare the five elements of the healthcare system. The study also used a Mann-Kendall test to analyze the trend of the PARC values from 2000 to the present year. The findings of the study indicate that many South Korea's PARC values were higher than the OECD median. But practicing physician in supply part and medical cost were lower than OECD median but the trend significantly increased. Medical accessibility part and quality of care part except primary care, and mental health had a high relative position but the trend did not increased significantly. After outbreak of coronavirus disease 2019, there were changes in medical accessibility. Health screening and vaccinations showed an overall decline in 2020 compared to 2019. These results suggest that policymakers need to take necessary steps for a sustainable healthcare system in the country.

A Study on the Child Care Providers' Perception on the Seoul-Type Child Care Accreditation System (서울형 어린이집 공인인증에 대한 보육시설 종사자의 인식연구)

  • Kim, Young Ok;Choi, Inhwa
    • Korean Journal of Childcare and Education
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    • v.7 no.2
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    • pp.181-203
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    • 2011
  • The purposes of this study were to examine the perception of directors and child care providers regarding the Seoul-type Child Care Accreditation and its operating system. The objects were 309 directors and child care providers at accredited Seoul-type child care centers. The collected data was analyzed using frequency, percentiles, and ${\chi}^2$. The results are as follows: First, the majority of directors and child care providers perceived 'the preparation for effective quality control of child-care service' as the primary purpose of the Seoul-type Child Care Accreditation. Many of them responded that the child care centers meeting the purpose of accreditation would be 'private' and 'home-based' ones. Seoul-type Child Care Accreditation was easier to pass compared to National Child Care Accreditation. The directors and child care providers perceived that the accreditation will narrow the gap between public and private child care centers. Second, in operating customized child-care service, most directors preferred 'submits only the same plan as that of a designated one', but most child care providers preferred 'assessment after providing customized child-care'. For the reliable child-care service and accounting management system, both subject groups showed general satisfaction with 'current system'. Third, both subject groups responded that 'overtime pay for child care providers' and 'government's consistent child-care policy' were what they desire most to improve Seoul-type Child Care Accreditation.

A Study on Effectiveness of Socheongryong-tang for Allergic Rhinitis : A Systematic Review and Meta-analysis (알레르기 비염에 대한 소청용탕(小靑龍湯)의 효과 평가 연구 : 체계적 문헌고찰과 메타분석)

  • Min, Kyung-Jin;Shin, Seon-Ho;Kang, Jeong-In;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.4
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    • pp.74-99
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    • 2020
  • Objectives : The purpose of this study is to assess the effectiveness and safety of Socheongryong-tang(SCRT) for allergic rhinitis(AR). Methods : We searched randomized controlled trials(RCTs) that used SCRT for AR in 8 databases(PubMed, Cochrane Library, CNKI, CiNii Articles, OASIS, NDSL, KISS, KMbase) from their inception until August 2019. The primary outcome was effective rate and scores evaluating the improvement of AR symptoms. The secondary outcome was quality of life scale, adverse events, recurrence rate, and laboratory indicators. Two researchers assessed the risk of bias in the included trials through the Cochrane Risk of Bias tool independently. The study synthesized outcomes using RevMan 5.3. Results : Eighteen RCTs involving 1686 participants were included in this review. The risk of bias was unclear for the majority of the included studies. Meta-analysis of 12 RCTs showed that there was no statistically significant difference between the SCRT group and usual care group in the effective rate(RR 1.18, 95% CI(0.98, 1.41), p=0.09, I2=46%). Meta-analysis of 5 RCTs showed that the combination treatment group of SCRT and usual care was significantly higher than the usual care group in the effective rate(RR 1.24, 95% CI(1.12, 1.38), p<0.0001, I2=0%). The SCRT group was more effective in improving nasal symptoms and quality of life than the placebo group according to one RCT. Mild adverse events such as dry mouth were identified in 5 RCTs, but no serious adverse events were reported. Conclusion : This review showed that in terms of the effective rate for AR, there was no statistically significant difference between SCRT and usual care and the combination treatment of SCRT and usual care was more effective than usual care. There were no serious adverse events. However, it is difficult to make a definite conclusion because of few included studies and heterogeneity between studies, and the quality of included studies was mostly insufficient. Further well-designed randomized controlled trials are needed.

Public Officials' Perceptions on Improving Quality of Community Health Care Service (공무원 인식유형에 따른 보건서비스 개선 방안)

  • Yang, Chang Hoon;Lee, Jei Young
    • The Journal of the Korea Contents Association
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    • v.14 no.1
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    • pp.223-237
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    • 2014
  • The purpose of this study is to understand the perceptions of public officials in improving primary health care service for local communities by applying Q methodology that draw upon schematic model in subjectivity study. A survey was carried out among public officials at Gangneung Community Health Center, South Korea, to classify the 49 selected Q-statements into a normal distribution using a 11 point scale. The collected data was analyzed using QUANL program, and principal component factor analysis using varimax rotation was used to identify public officials' perceptions of improving quality of health care for local communities as a meaningful service provider. Type I can be categorized by a strong concern for the service acceptance, Type II can be categorized by advocating for service usability, Type III can be categorized by the pursuit of service specialization, Type IV can be categorized by roles for service accessibility, and Type V can be categorized by the suggestions for operation and management. The results provide information used to further improve quality of community health care service with the aim to promote the effectiveness of health care delivery and to increase health service utilization.