• Title/Summary/Keyword: medical delivery system

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A Comparative Study on Primary Health Care in Republic of Korea and Republic of Uzbekistan

  • Dronina, Yuliya;Moon, Jiyoung;Nam, Eun Woo
    • Health Policy and Management
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    • v.27 no.3
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    • pp.256-266
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    • 2017
  • Background: Primary health care (PHC) plays a major role to ensure the basic right and equal distribution of the essential health care services. This study presents comparative analyses of PHC in Korea and Uzbekistan, discusses the existing scenario and the challenges, and provides recommendations. Methods: This study reviewed secondary data from Korea's National Statistical Information Service and the State Committee of the Republic of Uzbekistan on Statistic, regulatory legislation, research reports, and policy papers by research and international institutions. We focus on comparing input and outcome health data, PHC structure, and health expenditure. Results: Overall health status of the population in Korea is better than in Uzbekistan; both countries achieved more than 95% immunization coverage. The reforms implemented in both countries provide initial health care service delivery. However, there are several challenges such as the distribution of the staff between urban and rural areas and interest of the graduates on specialization rather than working in PHC system. Conclusion: PHC plays an important role in the provision of medical services to the population, addressing both health and social problems; it is the best tool for achieving universal coverage for basic health needs of the population. The community health practitioners in Korea and nurses in Uzbekistan plays main role in universal coverage through providing essential health care services. Continuous reform of the PHC system should be directed to strengthen the capacity of the PHC staff in health promotion knowledge and activities as well as to encourage population to improve their own health.

Analysis of the Results of Health Service Programs in the Primary Health Care Posts (보건진료소 보건사업 현황 분석)

  • Son, Gye-Soon;Moon, Ja;Park, Choon-Hee;Lee, Eun-Gyung
    • Journal of Korean Academy of Rural Health Nursing
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    • v.3 no.1
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    • pp.24-33
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    • 2008
  • Purpose: To analyze health programs of the PHCP (Primary Health Care Posts) Method: From August 2006 to July 2007, data on the general quality and health program of the PHCP was requested by official letter and replies were received via E-mail. From December 8 to December 30, 2007, data from 1,268 (66.8%) PHCP out of 1,897 PHCP were analyzed using SPSS 12.0 Win program. Results: The average population covered by each PHCP is 878.3 people. For the health and special programs, Community Health Practitioners report high motivation for programs on health promotion, management of chronic illness, social welfare (40-50%). Demand by the residents was reported at 10% and increases in the health of the residents were attributed to high interest and demand. Volunteer work was 83.3% for bathing, 54.5% for equipment support and 46% for exercise programs. As elders make up 30% of the population in rural areas, there is an increasing demand for volunteer work in bathing programs. Conclusions: As the number of elders in the population increases and there is an increased need for more medical treatment for older people who are sick, the role of PHCP must be strengthened to include visits to homes of community residents. Where financial support for the PHCP is difficult, it is necessary to develop sound data on demographic characteristics of the population in order to develop efficient and effective health promotion programs. The finding that 54.7% of the population need management of chronic illness has difficulty in seeing a physician indicates a need to enhance the health care delivery system by strengthening the role of the Community Health Practitioners and including them in the civil service system to ensure stability of the PHCP.

A Study on Awareness of Depression and Needs of a Depression Support Program in the University (일 대학 대학생의 우울증 인식도 및 우울증 지원프로그램 수요조사)

  • Kim, Woo-Jae;Kim, Sul-Min;Kim, Eun-Kyung;Kim, Kyoung-Hoon;Song, Ji-Young;Paik, Jong-Woo
    • Anxiety and mood
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    • v.6 no.1
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    • pp.55-64
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    • 2010
  • Objective : Depression is a significant and growing problem among college students. Depression contributes to numerous academic, social, and health problems, including suicide. This study surveyed depression awareness and the need for establishing a depression support program through Kyunghee University. Methods : We used the Kyunghee University Mail delivery system for college students to conduct this survey on depression and depression. Results : All of the students who responded to the survey, 41.86% reported that they had experienced depression. Among students experiencing depression, 27.27% experienced suicidal ideation, and 56.56% said they wanted to receive mental health counseling or treatment. All the respondents, 47.04% of respondents said they would to go to the external medical center, not school's internal counseling center of school, for such treatment. All the respondents, 73.75% said the student depression/suicide problem was serious. In addition, 71.34% of respondents required a depression support program. Conclusion : The university's depression support program needs to improve its accessibility by developing content focused on the early detection of, and improved awareness of, depression.

Stakeholders' Perception of the Introduction of Specialized Hospitals for Urologic Diseases: Qualitative Study (비뇨기 질환 전문병원 도입에 관한 이해당사자의 인식: 질적 연구)

  • Jeong, Hye-Ran;Pyo, Jee-Hee;Choi, Eun-Young;Kim, Ju-Young;Park, Young-Kwon;Ock, Min-Su;Lee, Won;Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.27 no.2
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    • pp.2-17
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    • 2021
  • Purpose: The purpose of this study is to seek in-depth perspectives of stakeholders on the necessity and specific criteria for designating a specialized hospital for urologic diseases. Methods: Eight participants experts in urology medicine and specialized hospital system were divided into four groups. Following the semi-structured guidelines, an in-depth interview was conducted twice and a focus group discussion was conducted three times. All the interviews were transcribed verbatim and analyzed. Results: The majority of participants predicted that there would be demand for specialized hospitals for urologic diseases. The criteria of designating a specialized hospital, such as the number of hospital beds and quality of health care, have to be modified in consideration of the specificity of urology. The introduction of a specialized hospital would improve the healthcare delivery system, positively affecting hospitals and patients. Furthermore, government support is essential for the maintenance of specialized hospital systems as urology hospitals experience difficulties in generating profits. Conclusion: This study is expected to be used as base data for introducing and operating a specialized hospital for urologic diseases. In addition, it is expected that the methodology and results of this study would encourage follow-up studies on specialized hospitals and provide guidelines to evaluate the effectiveness of such hospitals in other medical fields.

Analysis of the Contents of Visiting Nursing Articles on Domestic Portal Sites Using Topic Modeling: Focusing on the Comparison Before and After Coronavirus Disease (토픽 모델링을 이용한 국내 포털사이트 방문간호 기사 내용 분석: 코비드-19 이전과 이후 비교를 중심으로)

  • Lim, Ji Young;Lee, Mi Jin;Kim, Geun Myun;Lee, Ok kyun
    • Journal of Home Health Care Nursing
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    • v.30 no.2
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    • pp.141-154
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    • 2023
  • Purpose: This study aimed to explore the social perception of visiting nursing before and after coronavirus disease (COVID-19). Methods: This survey-based study used online big data for comparative analysis by classifying the keywords related to visiting nursing searched on domestic portal sites before and after COVID-19. Results: According to the results of analyzing the Intertopic Distance Map based on Latent Dirichlet Allocation in this study, four topics were extracted, two each before and after COVID-19. The first topic before the COVID-19 period was termed "the expansion of visiting nursing subjects and services visiting nursing," while the second was termed "visiting nursing," which is related to customized welfare. The first topic after the COVID-19 period was termed "the suspension and resumption of visiting nursing services," while the second was "the development of a non-face-to-face home visit healthcare system". Conclusion: The results of this study can be used as useful reference data to contribute to future medical service delivery system reform policies starting at the end of COVID-19 and the revitalization of community care for visiting nursing.

A study on the accessibility and utilization satisfaction of health centers in rural area, Paraguay (파라과이 농촌지역의 보건소 건립 후 접근성과 이용만족도에 관한 연구)

  • Kim, Ji Eon;Chung, Min Ah;Nam, Eun Woo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.29 no.2
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    • pp.17-26
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    • 2023
  • Purpose: The purpose of this study is to identify policy implications for the construction of public health facilities in the field of international cooperation, by examining the case of establishing a health care delivery system using a public health center in a rural area of Paraguay. Methods: Firstly, to map the capacity of the 20 public health centers that were studied, we used the WHO Capacity Mapping tool to select and analyze relevant items. Secondly, to assess the utilization of public health centers, we conducted a direct visit survey and analyzed the results using the M-survey tool. Results: The floor plan of each public health center, the structure of the health center, the size of the population served by each health center, the number of monthly visitors, medical human resources, and the budget were classified by health center for comparative analysis. In addition, by utilizing the M-survey tool, we analyzed the general characteristics of the respondents, their perceptions of the purpose and accessibility of public health centers, their satisfaction with using public health centers, and the level of demand for public health centers to play a role in promoting community health. Implications: The results of this study suggest that access to public health facilities for residents in the research area was improved. By classifying public health centers into two types, these centers can perform the functions and roles of primary health facilities. A patient request and evacuation system was established in the research area. Finally, a network, such as a social prescribing program, is needed so that public health centers can function as a "setting" for community members to live together.

Standardization Plan for Clinical Practice of the Physical Therapy Education in South Korea (대한민국 물리치료 임상실습 표준화 방안)

  • Ki-Song Kim;Yeon-Sub Lee;Tae-Sik Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.3
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    • pp.93-100
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    • 2024
  • Purpose : This study aims to review the physical therapy training programs in the United States, Canada, Taiwan, and Japan, and propose standardization plan for clinical practice in physical therapy education to advance the development of physical therapy education in South Korea. Methods : This study investigates the clinical practice standards in advanced countries such as the United States and Canada, and refers to the clinical practice standards in Taiwan and Japan, which are members of the association of world phyisotherapy and have economic, cultural, educational, and healthcare delivery systems, as well as legal systems, similar to those of South Korea. Results : In the United States, physical therapy education programs allocate an average of 22 weeks and 880 hours for clinical practice. Foreign-trained physical therapists who wish to take the licensure exam in the United States must have their educational programs reviewed and recognized as having completed at least 1,000 hours of clinical practice. In Canada, physical therapy education programs allocate an average of 31 weeks and 1,240 hours for clinical practice. Taiwan allocates over 1,440 hours of clinical practice in its educational programs, while Japan requires 800 hours of clinical practice as a legal prerequisite for the licensure exam. Conclusion : Based on the results of this study, the following standardization plan for clinical practice of the physical therapy education in South Korea are proposed. First, a minimum of 16 weeks and 640 hours of clinical practice is necessary to produce competent physical therapists. Second, university-based basic practical training should be at least 440 hours, with the introduction of a standardized accreditation system and unification of the four-year academic system. Third, the qualifications of physical therapists who supervise clinical practice in medical institutions should be clearly defined in the curriculum, and the standards for clinical practice instructors need to be expanded.

Comparison Study of Conventional Film-based and CT-reconstruction method in HDR Brachytherapy (고선량률 근접 방사선 치료에서 기존의 필름 방법과 CT 재구성 방법의 비교 연구)

  • 장지나;이형구;윤세철;서태석
    • Progress in Medical Physics
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    • v.15 no.2
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    • pp.63-69
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    • 2004
  • HDR brachytherapy administers a large dose of radiation in a short time compare with LDR, and its optimization for treatment is related to several complex factors, such as physical, radiation and optimization algorithms, so there is a need for these to be verified for accurate dose delivery. In our approach, a previous study concerning the phantom for dose verification has been modified, and a new pelvic phantom fabricated for the purpose of localization, including a structure enabling the use of a CT or MRI system. In addition, a comparison study was performed to verify an orthogonal method that is commonly used for brachytherapy localization by comparing target coordinates from a CT system. Since the developed phantom was designed to simulate the clinical setups of cervix cancer, it included an air-filled bladder and a rectum structure shaped sphere and cylinder An N-shaped localizer was used to obtain precision coordinates from both CT and films. Moreover, the IDL 5.5 software program for Windows was used to perform coordinates analysis based on an orthogonal algorithm. The film results showed differences within 1.0 mm of the selected target points compare with the CT coordinates. For these results, a Plato planning system (Nucletron, Netherlands) could be independently verified using this phantom and software. Furthermore, the new phantom and software will be efficient and powerful qualify assurance (QA) tools in the field of brachytherapy QA.

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A Study on Patients' Satisfaction and Service Utilization in the DRG Based Payment System - Patients who Experienced Cesarean Section Before and After the Demonstration Program - (DRG 지불제도에서 환자의 의료서비스 만족도와 제공량에 관한 연구 - 시범사업 전.후 제왕절개 분만 경험 산모를 대상으로 -)

  • Kim, Ji Sook;Park, Hayoung
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.190-202
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    • 2000
  • Background : The objectives of this study were to examine patients' satisfaction with the DRG based payment method and its association with their awareness of the method, to examine patient reported changes in doctors' caring attitude, level of their out-of-pocket payments, providers' acceptance of patients' request for additional services after the program, and to examine changes in service utilization recorded in medical records. Method : One hundred-four patients who had cesarean sections before and after the demonstration program at two hospitals located in Seoul participated in the study. Patients were surveyed before discharges when their charges were finalized. Their medical records were reviewed as well to collect data for service utilization during hospital stays. The association between patients' satisfaction with the payment method and their awareness of the method was analyzed by ${\chi}^2$-test, and the significance of changes in providers' acceptance of patients' request for additional services and service utilization after the program were examined by ${\chi}^2$-test and t-test, respectively. Results : A large proportion of patients did not know of the DRG based payment method at the time of survey and a significantly larger proportion of patients who came to the hospitals with the knowledge satisfied with the method. About the same proportion of patients reported improvement and deterioration in doctors' caring attitude compare to the previous hospitalizations and a similar result was found concerning out-of-pocket payments. Providers' acceptance of patients' request for medication, PCA and painless delivery decreased significantly after the program whereas the acceptance for additional hospital days and laboratory and radiology tests did not. Length of stay, the numbers of days on antibiotics and antianemic medication, and the number of blood tests decreased significantly after the program, however, decreases in the rate of antianemic medication and the number of urine analyses were not statistically significant. Re-operation, in-hospital death, and complications were not observed before and after the program. Conclusion : The study findings indicated a need for better patient education and publicity about the newly introduced payment method to improve their satisfaction with the system. Other study findings concerning service utilization and quality of care indicators were consistent with the government funded evaluation studies.

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A Pilot Study for the Remote Monitoring of IMRT Using a Head and Neck Phantom (원격 품질 보증 시스템을 사용한 세기변조 방사선치료의 예비 모니터링 결과)

  • Han, Young-Yih;Shin, Eun-Hyuk;Lim, Chun-Il;Kang, Se-Kwon;Park, Sung-Ho;Lah, Jeong-Eun;Suh, Tae-Suk;Yoon, Myong-Geun;Lee, Se-Byeong;Ju, Sang-Gyu;Ahn, Yong-Chan
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.249-260
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    • 2007
  • Purpose: In order to enhance the quality of IMRT as employed in Korea, we developed a remote monitoring system. The feasibility of the system was evaluated by conducting a pilot study. Materials and Methods: The remote monitoring system consisted of a head and neck phantom and a user manual. The phantom contains a target and three OARs (organs at risk) that can be detected on CT images. TLD capsules were inserted at the center of the target and at the OARs. Two film slits for GafchromicEBT film were located on the axial and saggital planes. The user manual contained an IMRT planning guide and instructions for IMRT planning and the delivery process. After the manual and phantom were sent to four institutions, IMRT was planed and delivered. Predicted doses were compared with measured doses. Dose distribution along the two straight lines that intersected at the center of the axial film was measured and compared with the profiles predicted by the plan. Results: The measurements at the target agreed with the predicted dose within a 3% deviation. Doses at the OARs that represented the thyroid glands showed larger deviations (minimum 3.3% and maximum 19.8%). The deviation at OARs that represented the spiral cord was $0.7{\sim}1.4%$. The percentage of dose distributions that showed more than a 5% of deviation on the lines was $7{\sim}27%$ and $7{\sim}14%$ along the horizontal and vertical lines, respectively. Conculsion: Remote monitoring of IMRT using the developed system was feasible. With remote monitoring, the deviation at the target is expected to be small while the deviation at the OARs can be very large. Therefore, a method that is able to investigate the cause of a large deviation needs to be developed. In addition, a more clinically relevant measure for the two-dimensional dose comparison and pass/fail criteria need to be further developed.