Exploring the Health and Social Needs of Community Residents Using an Online Community Care Platform: Linkage to the International Classification of Functioning, Disability, and Health / 대한의료정보학회지

Objectives@#This study aimed to analyze the outcomes of the Comprehensive Health and Social Need Assessment (CHSNA) system, which identifies community residents’ health and social needs, and to link these needs with the International Classification of Functioning, Disability, and Health (ICF). @*Methods@#Adult community residents in a metropolitan city in Korea were recruited. They were asked to assess their health and social needs via the CHSNA system, which was integrated into an online community-care platform. Three assessment steps (basic health assessment, needs for activities of daily living, and in-depth health assessment) associated with five ICF components were used to evaluate physical health impairment, difficulties in activities and participation, and environmental problems. The final list of health and social needs was systematically linked to the domains and categories of the ICF. Only data from participants who completed all three assessment steps were included. @*Results@#Wide ranges of impairments and difficulties regarding the daily living activities, physical health, and environmental status of the community were recorded from 190 people who completed assessments of their health and social needs by the CHSNA system. These participants reported various health and social needs for their community life; common needs corresponded to the ICF components of body functions and activities/participation. @*Conclusions@#The ICF may be suitable for determining the health-related problems and needs of the general population. Possible improvements to the present system include providing support for completing all assessment steps and developing an ICF core set for an enhanced understanding of health and social needs.

ICT-Based Comprehensive Health and Social-Needs Assessment System for Supporting Person-Centered Community Care / 대한의료정보학회지

OBJECTIVES: This study developed an information and communication technology (ICT)-based comprehensive health and social-needs assessment (CHSNA) system based on the International Classification of Functioning, Disability, and Health (ICF) with the aim of enhancing person-centered community care for community residents and supporting healthcare professionals and social workers who provide healthcare and social services in the community. METHODS: Items related to a CHSNA tool were developed and mapped with ICF codes. Experts validated the CHSNA system design and process using the Delphi method, and a pilot test of the initial version of the system was conducted. RESULTS: The following three steps of CHSNA were embedded in the system, which had a user-friendly screen and images: basic health assessment, life and activity assessment, and in-depth health assessment. The assessment results for the community residents were presented with visualized health profiles, including images, graphs, and an ICF model. CONCLUSIONS: The developed CHSNA system can be used by healthcare professionals, social workers, and community residents to evaluate the reasoning underlying health and social needs, to facilitate the identification of more appropriate healthcare plans, and to guide community residents to receive the best healthcare services. A CHSNA system can improve the implementation of standardized terminology utilizing the ICF and the accuracy of needs assessments of community residents.

Development of the evaluation tool for the food safety and nutrition management education projects targeting the middle class elderly: Application of the balanced score card and the structure-process-outcome concept / 한국영양학회지

PURPOSE: The aim of this study is to develop an evaluation tool for operation of food safety and nutrition education projects for middle class elderly using the concept of the balanced score card. METHODS: After the draft of the evaluation tool for the elderly training projects was completed, it was revised into the questionnaire and the validity of the indicators was tested by the Delphi group. The validity of the indicators was rated using a 5-point scale. The Delphi group consisted of 26 experts in the education sector, 16 government officials, and 24 professionals of the related area in communities. The first round test was conducted from July 9 to July 17, 2012, and 45 persons responded. The second round test was conducted from July 18 to July 25 and 32 persons responded. RESULTS: The indicators, which were answered by more than 75 percent of the experts as 'agree' (4 points), 'strongly agree' (5 point) were included as the final indicators for the evaluation tool: 28 items out of 36 in outcome perspectives, 9 items out of 12 in process perspectives, and 17 out of 20 items in structure perspectives. The score was allocated as 50 points for outcome indicators, 20 points for process indicators, and 30 points for structure indicators. CONCLUSION: Completion of the evaluation tool is a prerequisite to determine whether the program is effectively implemented. The monitoring tool developed in the study could be applied for identification of the most optimal delivery path for the food safety and nutrition education program, for the spread of the food safety and nutrition education program for middle class elderly.

The Respiratory Morbidities in Late-preterm Infants Compared with the Early-preterm and Term Infants throughout the First Year of Life

PURPOSE: We examined the respiratory morbidities in late-preterm infants compared to those of the early-preterm infants and term infants throughout the first year of life. METHODS: Data were retrospectively collected for 87 late-preterm, 72 early-preterm, and 608 term infants who were admitted to NICU and the nursery of Busan St. Mary's Medical Center from Jan 2007 to Oct 2009. RESULTS: There were significant differences in the proportions of the out-born infants, twin pregnancy, small for gestational age, and Caesarean section in the three groups (P<0.05). Late-preterm and early-preterm infants had longer duration of hospitalization, larger proportions of respiratory distress syndrome, mechanical ventilation at birth, oxygen therapy after 48 hours of birth, oxygen dependency at 28 days, and continuous positive airway pressure support at 28 days compared to term infants during the neonatal period (P=0.000). Late-preterm infants and early-preterm infants were re-admitted more often than term infants during the first year of life (P=0.000). Also Late-preterm and early-preterm infants had increased chance of respiratory tract illness than term infants (P=0.001). CONCLUSION: In this study, we demonstrated that there are higher chances of respiratory morbidities in the late-preterm infants than the term infants either during the neonatal period or throughout the first year of life, although early-preterm infants showed greatest respiratory morbidities.

A Study on Cost Analyses and an Efficient Financial Management in Self-Operated and Contract-Managed Secondary School Foodservices

Efficient financial management is a critical factor in achieving school foodservice goals. The objective of this study was to suggest efficient financial management practices in secondary school foodservices. In pursuit of this objective, we first identified performance indexes for measuring the success of financial management. Second, we suggested financial management standards, financial data classification methods and a report system. Last, we analyzed operating ratios with the financial data of self-operated and contract-managed school food services. The data were collected through an open-ended questionnaire from 10 middle/high school foodservices in Seoul and Kyeonggi Provincial during on-sites visits and interviews with dieticians and managers. Student participation, sales goals, re-contract frequency and number and cost of disaster loss were identified as the performance indexes for financial management. Income statements were compiled by identifying and classifying financial data. Total revenues consisted of subsidies, meal sales, other revenue and interest. Expenditures consisted of purchased food, salaries and wages, utility costs, office supplies, kitchen supplies, purchased services, company overhead indirect costs, facility investment and maintenance, facility usage expenses, employee benefits and miscellaneous. Mean price of a meal was 2,326 won at self-operated foodservices when the subsidies were included as revenues and 2,360 won at contract-managed foodservices. When including the subsidies as revenues, the operating ratios of self-operated foodservice showed that the food cost percentage was 66.9%, labor cost 23.2%, operation cost 9.9% and profit 0%. The correspond figures at contract-managed foodservices were 57.6%, 21.5%, 15.3%, and 5.5%, respectively. Food costs in self-operated foodservices was significantly higher than that for contract-managed foodservices, however, facility investment and maintenance and facility usage expenses at self-operated foodservices was significantly lower than those for contract-managed foodservices. Based on this study, the methodology and classification system of financial data was found to be applicable to assess the financial structure of school foodservices.