• 제목/요약/키워드: health services research

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원격의료서비스 수용요인의 구조적 관계 실증연구 (Structural Relationships Among Factors to Adoption of Telehealth Service)

  • 김성수;류시원
    • Asia pacific journal of information systems
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    • 제21권3호
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

한국 보건진료원 제도의 시작 (Beginnings of the Community Health Practitioner (CHP) System in Republic of Korea)

  • 이꽃메
    • 한국농촌간호학회지
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    • 제4권1호
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    • pp.31-40
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    • 2009
  • Purpose: This research was done do identify and analyze the beginnings of the community health practitioner system in the Republic of Korea (ROK) around 1980. Method: Primary sources were collected and analyzed, mainly newspapers around 1980, the act for health service for rural areas, and other relative publications. Results: The government of the ROK was trying to solve the problem of doctorless villages and regarded the introduction of primary health care (PHC) services using registered nurses (RNs) to be an economic solution to this problem. The Korean Nurses' Association presented 'a plan for community health service' to the government party and medical association in 1976. In this plan, RNs would provide primary care at the sub-county (myun) level, and hospital would provide secondary care. The Korean Public Health Development Research Center was awarded the project 'RNs and nurse aids as CHP for primary care service and their training'. In 1977, 25 RNs began to work as PHC in 3 areas, and interim findings showed that RNs were very capable of doing PHC. The Ministry of Health and Welfare announced long term plans for health and welfare administration including a tertiary health care delivery system. RNs after training were posted to rural areas with no medical services to do medical treatment for mild cases. The Act for health services for rural areas was enacted on December 31, 1980. Enforcement Ordinance and Enforcement Regulations were enacted in 1981. In 1981, 257 CHP were selected, trained, and deployed. In 1983, the president of the ROK announced continuation of the CHP system for residents of medically vulnerable areas. The number of CHP increased from 257 in 1981 to 2038 in 1989.

한국 노인의 치과 의료 필요와 치과 서비스 이용의 관련성 (The relationship between dental care needs and dental service use in Korean elderly)

  • 박민선;최보율;김유미
    • 한국치위생학회지
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    • 제20권6호
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    • pp.819-829
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    • 2020
  • Objectives: This study aimed to assess the relationship between dental care needs and dental service use in Korean elderly. Methods: Using the sixth Korea National Health and Nutrition Examination Survey, from 22,948 individuals, 1,572 (male 701, female 871) elderly individuals aged above 65 years were included in the study. All analyses were stratified by sex. Results: In males, the group with subjective needs was 3.74 (95% confidence interval [CI]: 2.58-5.41) times more likely to use dental services than the group without subjective needs. For females, the group with subjective needs was 2.17 (95% CI: 1.57-2.98 ) times more likely to use dental services than the group without subjective needs. Conclusions: To conclude, the elderly with symptoms, used the dental services for pain relief and functional recovery. Fundamental efforts to improve oral health are needed, such as providing treatment, prevention and educational services, besides efforts to provide treatment-oriented dental services. Further research is needed for the middle and elderly individuals who are in the blind spot of the existing policy.

Public Reporting of Hospital Level Surgical Volumes: Its Influence on Patient Behavior

  • Han, Kyu-Tae;Park, Eun-Cheol;Nam, Chung-Mo;Kim, Tae-Hyun;Hahm, Myung-Il;Lee, Sang-Gyu
    • 한국의료질향상학회지
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    • 제24권2호
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    • pp.62-75
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    • 2018
  • Purpose: The objective of this study was to publicly report the hospital-level surgical volume for 7 types of surgery including gastrectomy. Also, to investigate the changes in patient behaviors after the public reporting among patients with gastrectomy. Methods: This study used data from the National Health Insurance Service Cohort. The data comprised of 2,214 patients who were diagnosed with gastric cancer and underwent gastrectomy during 2004-2012. An interrupted time series analysis was performed to investigate the association between patients' choice and public reporting. Results: 79.27% of the patients visited a hospital with high surgical volume. The time trend after introduction of public reporting was positively associated with visiting a high volume hospital (per 1 month, RR: 1.004, p=0.0329). However, after adjusting the health policies by reducing copayment, public reporting on surgical volume was not associated with visiting a high volume hospital. Sub-group analyses had also similar results. Conclusion: Patients were more affected by policies on economic support than on public reporting, and the changes in treatment options may have been affected by the increasing preference for large size hospitals. Thus, public reporting did not significantly improve the options available for patients and their decision making on health care utilization.

에티오피아 농촌지역 여자청소년을 위한 HIV 예방프로그램 개발 (Development of HIV Prevention Program for Female Youth in A Rural Area of Ethiopia)

  • 안현미;이현경;이태화;이정열
    • 보건교육건강증진학회지
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    • 제30권5호
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    • pp.113-124
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    • 2013
  • Objectives: The objective of this study was developing a community-based HIV prevention program to enhance the safe sexual behavior among rural Ethiopian female youth. Methods: A community-based HIV prevention program was developed using the Cox's Interaction Model of Client Health Behavior. The program development was carried out in four phases using a mixed research method: need-assessment which consisted of three steps (secondary-data analysis, key-informant interview, and focused-group interview); identification of preliminary program contents; expert's review of the program contents for the validity and cultural acceptability of the program; and refinement of the proposed program contents. Results: The HIV prevention program developed in this study consisted of three modules; the first module was for enhancing the youth's self-esteem, the second was for providing the youth with information regarding HIV/AIDS and safe sexual behavior, and the third was for improving the youth's communication skills and refusing skills. Conclusions: The need assessment and expert's review was very effective way to reflect sociocultural factors of rural Ethiopia for developing HIV prevention program for female youth. Further research is desirable for verifying the effectiveness of the developedprogram.

A Peer-support Mini-counseling Model to Improve Treatment in HIV-positive Pregnant Women in Kupang City, East Nusa Tenggara, Indonesia

  • Artha Camellia;Plamularsih Swandari;Gusni Rahma;Tuti Parwati Merati;I Made Bakta;Dyah Pradnyaparamita Duarsa
    • Journal of Preventive Medicine and Public Health
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    • 제56권3호
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    • pp.238-247
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    • 2023
  • Objectives: Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers' knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services. Methods: This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants. Results: Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs' side effects; and the quality of health workers and HIV services. Conclusions: There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.

Factors Affecting the Quality of Life of Korean Cancer Survivors Who Return to the Workplace

  • Han, Kyu-Tae;Park, Eun-Cheol;Kim, Sun Jung;Jang, Sung-In;Shin, Jaeyong;Kim, Chan Ok;Choi, Jaw Woo;Lee, Sang Gyu
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.8783-8788
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    • 2014
  • Background: Although the prevalence of cancer is increasing, it is no longer synonymous with death. The number of cancer survivors is estimated to be increasing due to development in medical treatments and social programs; cancer survivors are increasingly returning to work after long-term unemployment. Thus, we examined the quality of life (QOL) and the factors associated with return of cancer survivors to the workplace. Materials and Methods: This study was performed using the 2008 Community Health Survey administered by the Korea Centers for Disease Control and Prevention (N=548). We used Chi-square tests to compare demographic variables based on self-perceived health status, and analysis of variance (ANOVA) to compare QOL scores among groups. We also performed a mixed-model analysis of the relationship between QOL and factors at the workplaces of cancer survivors. Results: Based on the results of our study, the overall QOL of cancer survivors was associated with 'mutual respect', 'free emotional expression', occupation, and age. Moreover, different trends of QOL according to self-perceived health were identified on additional analysis. In the 'bad' self-perceived health group, QOL was significantly different according to income. The QOL of cancer survivors in the low-income group was lower than in the other groups. Conversely, the 'normal' group had a lower QOL caused by 'no mutual respect' and "no free emotional expression" in the workplace. The QOL in the 'good' group based on self-perceived health was higher in the younger age group. Conclusions: There may be a significant relationship between QOL and workplace factors for cancer survivors, although further study is needed to investigate this relationship in detail. This may facilitate formulation of policy and efforts to prevent and manage the decline in the QOL of cancer survivors returning to work.

지역사회서비스 네트워크 모형 개발을 위한 실태조사 - 농촌건강장수마을을 대상으로 - (A Study on the Actual Condition of Community-Oriented Services, Focusing on Senior Well-Being Villages)

  • 윤성인;박공주;윤순덕
    • 한국지역사회생활과학회지
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    • 제17권4호
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    • pp.67-80
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    • 2006
  • This study conducted research on the actual state of community-oriented services for elderly rural inhabitants and their desire related to them to develop a local community service network model suitable to the characteristics of rural longevity villages. The research was conducted on 906 elderly people over 65 living in 20 rural longevity villages through questionnaires assessing filming and economy, economic activity, health care, learning and leisure activities as well as asking their wants and needs relative to local community services. As a result, it was found rural elderly people showed a high desire for local community services such as health, transportation and economy activity. In addition, they were mainly cultivating farm products as their economic activity and showed a high demand in the future as well. Most were found to take a walk in the healthcare field and showed a high demand for health examinations, health education, health consulting, hot spring bathing and basking in the woods. Respecting learning, social and leisure activities, they were mostly found to watch TV and do house chores, and showed a high desire for village environment repair, traditional farm music, visiting and tourism. With the above results, it is expected that the desire of rural elderly for such services can be satisfied, and the development of a local community service network model suitable to the characteristic of a local community is recommended.

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조현병 환자의 범죄에 대한 대중의 관심과 조현병 환자의 정신의료서비스 이용과의 상관관계 (Public Attention to Crime of Schizophrenia and Its Correlation with Use of Mental Health Services in Patients with Schizophrenia)

  • 박현우;이유상;이상엽;이승연;홍경수;;권준수
    • 대한조현병학회지
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    • 제22권2호
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    • pp.34-41
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    • 2019
  • Objectives: This study was performed to examine the effects of the public attention to 'crime of schizophrenia' on the use of mental health services in patients with schizophrenia using big data analysis. Methods: Data on the frequency of internet searches for 'crime of schizophrenia' and the patterns of mental health service utilization by patients with schizophrenia spectrum disorders by month were collected from Naver big data and the Health Insurance Review and Assessment Services in Korea, respectively. Their correlations in the same and following month for lagged effect were examined. Results: The number of outpatients correlated negatively with public attention to 'crime of schizophrenia' in the same month. The lagged relationship between public attention and the number of admissions in psychiatric wards was also found. In terms of sex differences, the use of outpatient services among female patients correlated negatively with public attention in the same month while the number of male patients' admissions in both same and following month correlated positively with public attention. Conclusion: These findings suggested that public attention to 'crime of schizophrenia' could negatively affect illness behavior in patients with schizophrenia.

Public Health Center Service Experiences and Needs among Immigrant Women in South Korea

  • Chae, Duckhee;Kim, Hyunlye;Seo, Minjeong;Asami, Keiko;Doorenbos, Ardith
    • 지역사회간호학회지
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    • 제33권4호
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    • pp.385-395
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    • 2022
  • Purpose: To support implementation of comprehensive, person-centered healthcare, this study aimed to explore immigrant women's public health center (PHC) service experiences and needs while considering Photovoice's feasibility for this purpose. Methods: This qualitative study included 15 marriage-based immigrant women. Participants were recruited from churches and multicultural family support centers using purposive and snowball sampling. Data were collected through four focus group interviews and were subjected to inductive content analysis. Results: Five categories of experiences were identified: language barriers, hectic environment, affordable and practical primary healthcare, feeling ignored and discriminated against, and feeling frustrated. In addition, five categories of needs were identified: language assistance services, ease of access, healthcare across the lifespan, expansion of affordable healthcare, and being accepted as they are. This study provides preliminary evidence that the Photovoice approach can facilitate the interview process in a qualitative inquiry involving participants with limited ability to express their perspectives in the researchers' language. Conclusion: Study findings highlight the need to implement institutional policy and procedural changes within PHCs and to provide culturally competent, personcentered care for South Korea's marriage-based immigrant women and other ethnic minority populations. The findings also provide evidence-based direction for PHC service planning.