• Title/Summary/Keyword: unmet medical need

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Pharmacological interactions between intrathecal pregabalin plus tianeptine or clopidogrel in a rat model of neuropathic pain

  • Lee, Hyung Gon;Kim, Yeo Ok;Choi, Jeong Il;Han, Xue Hao;Shin, Yang Un;Yoon, Myung Ha
    • The Korean Journal of Pain
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    • v.35 no.1
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    • pp.59-65
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    • 2022
  • Background: There is still unmet need in treating neuropathic pain and increasing awareness regarding the use of drug combinations to increase the effectiveness of treatment and reduce adverse effects in patients with neuropathic pain. Methods: This study was performed to determine the individual and combined effects of pregabalin, tianeptine, and clopidogrel in a rat model of neuropathic pain. The model was created by ligation of the L5-L6 spinal nerve in male Sprague-Dawley rats; mechanical allodynia was confirmed using von Frey filaments. Drugs were administered to the intrathecal space and mechanical allodynia was assessed; drug interactions were estimated by isobolographic or fixed-dose analyses. Results: Intrathecal pregabalin and tianeptine increased the mechanical withdrawal threshold in a dose-dependent manner, but intrathecal clopidogrel had little effect on the mechanical withdrawal threshold. An additive effect was noted between pregabalin and tianeptine, but not between pregabalin and clopidogrel. Conclusions: These findings suggest that intrathecal coadministration of pregabalin and tianeptine effectively attenuated mechanical allodynia in the rat model of neuropathic pain. Thus, pregabalin plus tianeptine may be a valid option to enhance the efficacy of neuropathic pain treatment.

Health Status and Medical Care Utilization Patterns of Rural Aged (일부 농촌지역 노인들의 만성질환 유병상태와 의료이용 양상)

  • Oh, Jang-Kyun
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.3 s.35
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    • pp.328-338
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    • 1991
  • To find out the state of illness, patterns of medical care utilization, and factors which determine medical care utilization for aged we surveyed 679 rural old persons who live in the Chungnam province from Jan. 10 1991 to Jan. 19. The major findings of this study were as follows : 1. The morbidity rate of chronic illness during last 3 months was 56.4% for all surveyed old persons ; 58.7% for female and 52.8% for male. 2. As expected, 80 years old or above group showed the highest morbidity rate, 60.2% and the 65-69 years age group was the lowest, 50.5%. 3. Old persons who are householder, whose family income is less than 290,000 won per month, and who receive benifits from the public medical assistance program had relative higher morbidity rate than other groups and the difference was statistically significant (p<0.05). 4. The most frequent chronic illness was musculoskeletal disease, 49.6% ; the disease from which the aged had suffered for the longest period was gastrointestinal, 11.6yrs : the cerebrovascular was the disease which inflicts the lowest level of physical ability. 5. 67.1% of 383 persons who were suffering from chronic illness were in need of medical care but unmet ; among the remaining 32.9% who utilized medical care, 19.2% utilized it in local clinics or hospital OPD and 15% in th health centers or subcenters. 6. Old person who are married, whose sons are householder and whose family income is 500,000 won or above per month showed relative higher utilization rate than other groups and the difference was statistically significant (p<0.05). 7. The most common reason why the aged did not utilize, in spite of, need medical care was economic problem, 35.4%. For the aged whose family income per month is 500,000 won or above, however the most common reason was tolerable symptom, 46.9% while persons who answered economic problem were 6.1% of them, the lowest frequency.

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Health Care Utilization and Its Determinants among Island Inhabitants (도서지역주민의 의료이용양상과 그 결정요인)

  • Yu, Seung-Hum;Cho, Woo-Hyun;Park, Chong-Yon;Lee, Myung-Keun
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.2 s.22
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    • pp.287-300
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    • 1987
  • Island regions suffer from a shortage of health care in part because they are less developed, they cover a widespread area relative to the population, and due to transportation barriers. The purpose of this study was to assess the level of illness and the magnitude of medical care utilization, and to investigate the determinants of utilization in these area. The data were collected by means of a household survey conducted from February 16 to 25, 1987 on S islands which were selected in consideration of the size of the population, the distance from the main land, and the distribution of health care facilities. The household response rate was 89.1% (491 of 551 households), and 1971 persons were surveyed. The major findings of this study are as follows: 1) The morbidity rate of the island inhabitants was 27.7% during the two weeks, and 25.5 chronic illnesses and 9.1 acute illnesses per 100 persons, were noted. Differences in the magnitude of illness were statistically significant by sex, age, education, and family size. 2) The magnitude of total ambulatory carl utilization was 16.8 visits per 100 persons during the two weeks, which was less than that of other regions; and differences in the magnitude of total ambulatory care were statistically significant by sex, age, education, occupation, and family size. 3) Unmet needs were classified as 56.0% in chronic illnesses and 19.6% in acute illnesses; and differences in unmet needs were statistically significant by sex, age, education, occupation, income, and family size. 4) Statistically significant determinants in medical care utilization included the frequency of acute illness and chronic illness, and income in total utilization; the frequency of chronic illness and acute illness, and medical care insurance in physician visits. 5) According to the results of the path analysis, need factors had the greatest effect on utilization, and predisposing factors had more indirect effects through enabling or need factors than direct effects.

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Is a New Public Medical School Linked to Compulsory Service Necessary to Strengthen Public Health Care in Korea?: Who Wants to Build a New Public Medical School Linked to Compulsory Service? And Why? (우리나라 공공의료 강화를 위해 공공의대는 꼭 필요한가?: 누가, 왜 공공의대를 만들려 하는가?)

  • Han, Hee Chul
    • Korean Medical Education Review
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    • v.24 no.1
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    • pp.18-34
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    • 2022
  • The purpose of this study is to clarify the background of the controversial attempt to establish a new public medical school linked to compulsory service as a means of strengthening public healthcare in Korea, and to raise anticipated problems with possible solutions. In Korea, healthcare is predominantly provided by the private sector focused on medical care, rather than public healthcare, even under the national health insurance system. The government has been mainly in charge of public health and unmet medical services from a residual perspective, but health inequalities still exist. To resolve this issue, the government created the concept of public health and medical service (PHMS) from a universal perspective and tried to strengthen the infrastructure of public healthcare and to foster core PHMS doctors by establishing a new public medical school linked to compulsory service in medically vulnerable areas. This study investigated the reality and concept of the new public medical school planned by the government, and identified problems such as the possibility of obtaining accreditation and evaluation before its establishment, the side effects of dividing doctors' roles, the waste of huge amounts of resources, and insensitive policies. In conclusion, in order to resolve health inequalities in Korea, we need to train doctors through medical school education that strengthens the social responsibility of doctors along with strengthening public healthcare infrastructure, and to provide a better environment for doctors working in medically vulnerable areas through sophisticated policies.

Identifying the Needs of Home Care Patient's Family Caregivers (가정간호 가족 돌봄 제공자의 요구도)

  • Baek, Hee-Chong;Choi, Yun-Jung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.15 no.2
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    • pp.115-121
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    • 2008
  • Purpose: The purpose of this study was to identify the needs of family caregivers of home care patients. Methods: A total of 40 caregivers had been selected from a hospital-based home care agency in Gyunggi province. The instrument developed by Hileman, Lackey, & Hassanein(1992) was modified to 55 items and used in this study. The instrument consists of 6 categories: informational, household, patient care, personal, spiritual, and psychological needs. Out of 29 analysed with descriptive statistics, Mann-Whitney U test, and Spearman correlation test using SPSS 14.0. Results: Most caregivers were females, with a mean age of $60.0{\pm}15.5$, 32.1% were spouses, and 92.9% were living with patients. Patient's activities of daily living score was very low, and 44% of patients had cerebrovascular disease. Caregiver's needs were moderate, and the greatest being personal need. There was a significant difference between caregiver's monthly income and needs. Conclusion: Home care nurses need to teach and support family caregivers with specific programs and services to meet the identified and unmet needs of caregivers of home care patients. In-home respite and institutional respite are recommended for family caregivers taking care of patients with chronic disease.

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Experiences of hospitalization among pregnant women with preterm labor in Korea: a phenomenological study

  • Lee, Joon-Young;Song, Yeoungsuk
    • Women's Health Nursing
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    • v.27 no.3
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    • pp.209-219
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    • 2021
  • Purpose: The purpose of this study was to describe pregnant women's lived experiences of hospitalization due to preterm labor in Korea. Methods: This qualitative study adopted a phenomenological approach. Individual in-depth interviews were conducted with nine participants, over the age of 20 years, who had been hospitalized for more than 1 week after being diagnosed with preterm labor. All interviews were audio-taped and verbatim transcripts were made for analysis. The data were analyzed following Colaizzi's phenomenological method. Results: The participants' ages ranged from 26 to 36 years, and all were married women. They were hospitalized for 13.1 days on average. Five thematic clusters emerged from the analysis. 'Withstanding hospitalization for the fetus's well-being' describes women's feelings during preterm labor and their endurance during their prolonged hospitalization, rooted in their conviction that the fetus comes first. 'Endless frustration in the hospital' encompasses women's emotions while lying in bed and quietly thinking to themselves. 'Unmet physiological needs' describes participants' awareness of their inability to independently handle human physiological needs given the need for careful and limited movement. 'Gratitude for the support around oneself' reflects the support from family and medical staff. 'Shifting perceptions and accepting one's circumstances' describes accepting hospitalization and making efforts to spend their remaining time in the hospital in a meaningful way. Conclusion: The findings in this study provide a deeper understanding and insights into the experiences of Korean women with preterm labor during hospitalization, underscoring the need to develop interventions for these patients.

The Effect of Residential Migration on the Utilization and Accessibility of Medical Care (거주지역 이동이 의료이용량과 의료접근성에 미치는 영향)

  • Lee, Woo Ri;Choi, Yong Seok;Lee, Gyeong Min;Kim, Li Hyen;Yoo, Ki-Bong
    • Health Policy and Management
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    • v.31 no.1
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    • pp.125-139
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    • 2021
  • Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion: This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

Health related behavior patterns and associated factors among marriage immigrant women using latent class analysis (잠재계층분석을 활용한 결혼이주여성의 건강관련행동 군집유형과 영향요인)

  • Cho, Wonsup;Yoo, Seunghyun;Kim, Hyekyeong
    • Korean Journal of Health Education and Promotion
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    • v.32 no.5
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    • pp.17-31
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    • 2015
  • Objectives: This paper aims to identify the health related behaviors patterns and its associated factors among marriage immigrant women in Korea, and discusses their application to health promotion strategies. Methods: The study participants were 7,591 immigrant wives in Gyeonggi province who participated in health examinations conducted by the Korea Association of Health Promotion in 2011-2013. The participants completed self-administered questionnaires on sociodemographics, psychological characteristics, health status and health care factors, and health related behaviors. Results: A 3-latent-class model of health behaviors was identified related to 'lack of physical activity', 'abnormal diet', and 'not experienced medical check-up': 'high risk class', 'middle risk class', and 'low risk class'. Most of the participants belong to 'middle risk class'. Country of origin, age, length of stay, number of children, work status, health insurance status, and unmet health care needs were associated with problematic health behaviors in middle risk health behavior class. Conclusions: Health promotion and intervention programs for marriage immigrant women and their family members need to consider the health behavior patterns of physical inactivity, abnormal diet and no medical check-up and develop multiple behavior intervention with pre-existing program modification.

Comparisons of Awareness of Health Care Services and Characteristics in Persons with Speech-Language Disorder Related to Speech Therapy Use for Life Care : From National Survey of the Disabled Person of 2017 (라이프 케어를 위한 언어장애인의 언어치료 이용여부에 따른 특성 및 보건의료서비스 인식 비교 : 2017년 장애인 실태조사를 이용하여)

  • Kang, So-La;Moon, Jong-Hoon
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.3
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    • pp.249-258
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    • 2019
  • The health care services are the most basic social institutions that are provided to citizen including disabled persons for improvement of health. However, the study of the difference of health care services according to the speech therapy use in the people with speech-language disorders was insufficient. The aim of this investigation was to compare the awareness of health care services and characteristics of people with speech-language disorders according to speech therapy use. The researchers selected 229 people with language disorder using raw data of National Survey of the Disabled Person (2017). We compared the characteristics and health care services of people with speech-language disorders by distinguishing between speech therapy non-users and speech therapy users. Among the 229 people with language disorder, speech therapy users were 37 persons (16.2%). In comparison with non-users, users were younger, more preschoolers, more family incomes, and intellectual disabilities and autistic disorder were the most common types of disability enrollment. Users had a lower proportion of unmet medical needs than non-users. For the reasons of unmet medical need, there were 6.8% and 6.3% of the "economic reasons" and "communication difficulties" Both users and non-users responded that "disability management services" need to be strengthened by the government. In conclusion, we suggest that access to health care services needs to be increased to lower the barriers of speech therapy use.

Analysis of dental hygiene records applied by dental hygiene process (치위생과정을 적용한 치위생관리 기록부 분석)

  • Lee, Joon-Mee;Chung, Won-Gyun;Yoo, Jae-Ha;Kim, Nam-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.9 no.4
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    • pp.768-783
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    • 2009
  • Objectives : The purpose of this study was to analyze dental records performed through a dental hygiene process and provide basic data on clinical training education for dental hygienists. Methods : The dental hygiene records of 440 senior dental hygiene students in Y University from March 2005 to September 2008, were examined. The needs of the clients confirmed by the dental hygiene diagnosis was based on Human Need Theory. The client's needs and the number of visits were analyzed according to the general characteristics(gender, age). The contents of the dental hygiene implementation performed according to the needs were divided into dental hygiene care and oral health education. The dental hygiene evaluation was classified into 'Met of Goal', 'Partially Met of Goal', and 'Unmet of Goal' according to the dental hygiene diagnosis. Data analysis was performed for the Frequency statistics and a Fisher's exact test using SPSS 12.0K for Windows. Results : 1. The clients were mostly aged in their 20's(307 clients). 2. The dental hygiene care usually performed was 'Scaling' and 'Recommendation to visit a dental clinic', and the education performed was 'How to brush teeth'. The implementation result from the need to Freedom of Stress was as simple as 'Be careful when treating' and 'Explanation of medical treatment and tools'. 3. The dental hygiene evaluation showed a higher met rate in the field of education than in that of the dental hygiene care. The reason for unmet the goal was 'Lack of the client's efforts and they didn't visit dental clinic'. Conclusions : The search for a range of clients for dental hygiene process should be made through effective connections between the local community institutions and schools. It was suggested that they should be strength the practical exercises for clients suffering dental anxiety and stress in dental treatments. In addition, education and attempts to motivate the clients should be performed according to their characteristics.

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