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.
This study was intended to analyze whether there would be difference in awareness of the Evaluative Accreditation System(the administrative procedures of Evaluative Accreditation, the effect of Evaluative Accreditation, and the preferred public support types for encouraging participation in Evaluative Accreditation) between child-care directors and teachers, and among the types of child-care centers. The questionnaires were administrated to 168 child-care directors and 423 child-care teachers in Gyeonggido. Data analyses were conducted by descriptive statistics, the chi-test and the t-test. The main results were as follows. First, there was significant difference in awareness of the administrative procedures of Evaluative Accreditation among the types of child-care centers. Second, there was difference in awareness of the effect of Evaluative Accreditation on child-care service areas between child-care center directors and teachers, and among the types of child-care centers in terms of child-care services. Third, in terms of the preferred public support for the encouragement of participation in Evaluative Accreditation, there was difference between child-care center directors and teachers, and among the types of child-care centers.
Propose: This study was to identify the factors affecting the oral health status in vulnerable elders receiving home visiting health care service. Methods: A total of 444 elderly people over the age of 65 at 33 public health centers in Daegu and Gyungbuk areas were included in this survey. The data were collected by personal interview with nurses using oral health knowledge, behavior, and status questionnaires from the $10^{th}$ to $22^{nd}$ of July, 2012. The data were analyzed with t-test, one-way ANOVA, $Scheff{\acute{e}}$ test, and stepwise multiple regression, using SPSS program. Results: Factors affecting the oral health status were chewing satisfaction with denture 14.5% (${\beta}=.391$, p<.001), denture care (wash with water) 3.2% (${\beta}=-.187$, p<.01), and types of health insurance (medical aid type1, 2) 1% (${\beta}=-.111$, p<.05). The factors explained 18.7% of variance in the oral health status of vulnerable elderly subjects. Conclusion: The results of this study indicate that in order to improve the oral health status of vulnerable elders, it is necessary to provide oral health education that includes the proper usage of denture to elders who receive home-visiting care.
To analyze of determinants influencing the utilization of the rural health sub-centers (HSCs), 116 of 144 HSCs in Kyong Gi Do, were selected for this study. The self-administered questionnaire covering the environment and the characteristics of doctors working in the HSCs was sent to HSCs by mail. 105 questionnaires were returned of which 88 were completed and use in the study. The dependant variable was the total number of medical care visits to the HSCs from January 1, 1990 to March 31, 1990. Data was analyzed by multiple regression analysis. The results were as follows : First, the more time required to set from the HSCs to nearest hospital or clinic, the higher the utilization of the HSCs. Second, the more geographically accessible the HSCs was, the more utilization the HSCs. Third, the older of the HSCs doctors were, the more utilization of the HSCs. Fourth, the higher frequency of bus service from the HSCs to town, the more utilization of the HSCs. Fifth, the more time required from the HSCs to town, the more utilization of the HSCs. Therefore, the determinants influencing the utilization of the rural HSCs in Kyong-Gi Do, are mostly geographical accessibility of medical care.
The MLVA assay is known to have a high ability to identify and discriminate Brucella species, so that it can be used as an epidemiological tool to discriminate Brucella isolates originating from restricted geographic sources. In this study, the genetic profiles of 38 B. abortus isolates from humans were analyzed and compared with genotypes from animal isolates in South Korea. As a result, it was found that they did not show high genetic diversity and were compacted. They were clustered together with animal isolates, showing a significant correlation to regional distributions. With its ability to prove a significant genetic correlation among B. abortus isolates from animals and humans in South Korea, the MLVA assay could be utilized as part of a program to control and eradicate brucellosis, one of the major zoonoses. This study represents the first data of genetic correlation of B. abortus isolates from humans and animals in South Korea.
Objectives: The purpose of this study was to identify basic health needs of adult clients to develop a community nursing center model in Seoul. Methods: Data were collected using a questionnaire survey from 894 adults registered at a public health center who were health management members, and visiting 4 community nursing centers, University of Wisconsin, Milwaukee during the period from July 1999 to January 2000. The data were analyzed using frequency, percentile, t-test, and ANOVA. Results: 1) The University of Wisconsin- Milwaukee School of Nursing has a long tradition of developing 4 community nursing centers with innovative health care programs. CNCs integrate the ability to implement and test effective intervention strategies with education, research, and practices of nursing students and faculty. They were designed to enhance the health status and quality of life for urban communities through the development of productive, outcome focused, collaborative partnerships among UWM-Nursing faculties and staff, other health and human service providers, consumers, and policy makers. It links the financial resources between UWM and 9 voluntary agencies and 12 public funding organizations including federal. state, and local governments. 2) Of the total health management members, 37.4% were reported to have at least one type of chronic disease such as hypertension, diabetes, and arthritis. Ten percent of them reported having obesity, and 44.2% reported lack of exercise. The health status of the subjects was within normal range in laboratory tests. However, female subjects showed more significant differences in obesity and cholesterol levels than male subjects. The subjects, who were in their 50s, showed more significant differences in obesity, SGOT, SGPT, and cholesterol levels than the subjects in other age groups. Conclusion: A community nursing center needs to be developed, that has a link between the nursing college and the public health center, with partnerships and a multidisciplinary approach. Based on the study results, exercise programs for middle aged adults are considered necessary. In particular, specific exercise programs for pre-menopausal women needs to be implemented in the future to prevent them from developing osteoporosis.
The purpose of the study is (i) to investigate the operating situation of physical therapy department in public health centers, (ii) to analyze the difference of elderly satisfaction from non-elderly satisfaction of physical therapy services among the public health center visitors, and finally (iii) to suggest facilitating improvement on programs that can supply the elderly health service through public health centers. A questionnaire survey was carried out 212 patients of 25 public health center in Seoul, Korea from 15 July to 10 August 1996. Major results of the study are as follows : 1. Among the respondents. the largest group was the elderly who are over 65 years old (72.6%). 2. The averge of general patients' satisfaction for physical therapy services was 3.98, especially fee of treatment(4.76), attitude of physical therapist(4.33), and reliance of physical therapist(4.20) were higher by 5-score Likert scale. 3. The correlation factors with general patients' satisfaction were process of treatment (r =.6301). results of treatment(r=. 6186), and guide facilities(r=.5999). 4. The results of multiple-regression analysis between general patients' satisfaction and affecting factors identify following variables as the statically significant determinants : general stisfaction comparing with other physical therapy services, physical therapy services using forwardly, fee of treatment. 5. There was no significant defference between elderly and non-elderly patients' satisfaction of physical therapy service, except attitude of physical therapist(t=-2.07), explanation of treatment for disease(t=-2.19), fee of treatment(t=6.29).
The purpose of this paper is to review the empirical study results of conversion factors(unit prices) for relative values of health care services in the national health insurance system and establish optimal classification of health care institutions for feasible contract of conversion factors between National Health Insurance Corporation(NHIC) and provider groups, based on legal backgrounds and types of health care service delivery system. some empirical research evidences shows the validity of applying multiple conversion factors to annual contract for reimbursement in the national health insurance. Policy recommendations suggest that clinic, hospital, general hospital, tertiary hospital, dental clinic, oriental medical clinic, pharmacy, and public health centers would be a basic category of provider groups for a meaningful price contract between the NHIC and providers.
Purpose: Through a thorough examination of the CCSC (Community Comprehensive Support Center) system in Japan, this study suggests a scheme to provide community-based preventive health care services for the elderly in Korea. Methods: The study inquired into the applicability of the Japanese model by reviewing the data related to the CCSC project, aided by both in-depth interviews with staff in the field and consultations with specialists. Results: Rearrangement of the Visiting Health Management Project system is needed to manage the collective or individual visiting care management for frailty prevention of the elderly in communities. The delegated service system for preventive care in the community, including direct management by one of the public health centers, also needs to be reviewed and the application of stricter standards for the selection of the agency or corporation to run the delegated service is necessary. Long-Term Care Insurance, along with national and local grants, is to be considered as a financial resource for the community-based preventive health care model for the elderly. By making active use of education rooms at district offices, senior citizen centers in neighborhoods for the elderly with easy access can be created. The project needs to raise active supports from communities, develop programs which can be absorbed into particular local cultures, and promote the understanding of the preventive project in local communities. The preventive program should focus on first solving the problems of depression, seclusion, and lack of mobility of the elderly. Second, the program should instruct physical self-management for exercise-nutrition-dental maintenance, and third, the program should strengthen the cognitive abilities of the elderly. In addition, it is necessary to systematize and implement counter-plans of the family and community to protect the elderly who has mental and cognitive problems. Finally, by establishing a network of public health welfare resources based upon research on a community level, assessment and planning for the health of the elderly should be one with their family, and comprehensive consultation and recommendations should be provided to the family. Conclusion: Taking into consideration the experience Japan has had with respect to a similar project, it is appropriate to develop and implement a service system which would combine the Visiting Health Management Project system which has already been established and a preventive health care model for the elderly on a community level.
The purpose of this study was to assess the needs of breast self examination education (BSEE) programs for developing nursing centers. A first, we reviewed the literature of activity and management-related factors of nursing centers: and, second. we used a questionnaire to discover the degree of knowledge, attitude, and practice on breast cancer, as well as an individual's intention to participate BSEE program. 1. Reviewing the literatures of nursing center activities. Nursing centers which were administered by a professional nurse are an ideal site for faculty and student practices. With the use of nursing models of health. professional nurses in nursing centers diagnose and treat human responses to potential and actual health problems and offer holistic, client-centered health service. In nursing centers professional nursing services include health education, health promotion, and health-related research. A nursing center is comprised of the advisory and exacutive commitee; the advisory commitee serves consultants and links community needs to the nursing center, while the director of the exacutive commitee identifies the potential resources to generate funds, support, and facilitate the activities of staffs in a nursing center. Nursing centers mobilize various financal resources for reimbursement of services from college and insurance companies, collect minimum service fees from the client, and further collect fees for providing programs to community groups, this also includes membership fees, and donations. The services provided by nursing centers focus on services related to primary prevention, health maintenance & health promotion, direct nursing care for acute & chronic diseases, and holistic care for actual and potential health problems. The client satisfaction for the services was high. Students also showed positive reponses for their clinical experiences and independent working conditions. 2. The degree of knowledge, attitudes, and practices for breast cancer. and an individual's intention to participate in the BSEE program. The subjects of this study were 308 females in K-city in the Republic of Korea. Data were collected using a self-administered questionnaire. The mean age of the respondents was 35.0 years old. Those who already participated in the BSEE were 64.9%, and those who had support and encouragement to practice BSE from significant others were 25.1 %. Clients intent to participate in the BSEE were 37.0%. The mean score of knowledge(2.4 out of 5 points) and practices(1.8 out of 5 points) for breast cancer were quite low, but the mean score of attitudes was relatively positive04.5 out of 20 point) for breast cancer. Those who already had BSEE showed significantly high scores in knowledge(t=6.48, p<0.01), attitudes (t=10.54, p<0.01). and practices(t=57.07, p<0.001) for breast cancer than those who had not participated in the BSEE. In all age groups no intention to participate in the BSEE was higher than who the intention to participate. These findings suggest some strategies should be developed to increase the awareness of breast cancer's early detection.
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