Medicare System and Family Doctor Training Program in Australia: A Study Tour to a Leading Country for Family Medicine / 日本プライマリ・ケア連合学会誌

In February 2017, general practitioners (GPs) from the Department of Community and Family Medicine of Fukushima Medical University in Japan visited Australia for a study tour where the tour participants met with local GPs, GP registrars and researchers. During this tour, we visited public hospitals and observed multiple GPs providing community-based health care. We also attended a new GP registrars' orientation where the two authors gave a presentation about the current status of primary care in Japan. We then visited an Aboriginal health research center, and learned about the cultural values of the Aboriginal people and the challenges of implementing large-scale cohort studies.

Primary Care Perspectives in Japan

With an increase in aging population and medical expenditure worldwide, primary care has been rising as a solution to these. Japan, a representative aging society which has the most elderly population in the world, also has tried to develop a primary care system and implemented many changes recently. Based on what authors experienced and observed at the points of care in Japan, we are going to review the primary care system and training strategy of family medicine in Japan and come up with some suggestions that could apply to Korea.

The development of a community-based medical education program in Korea / 한국의학교육

PURPOSE: The introduction of community-based medical education would help improve the quality of primary care. This paper suggests learning objectives and an educational program for community-based medical education. METHODS: The educational program was developed in a 1-day consensus workshop. Twenty experts, including faculty members from family medicine department of a college of medicine in Seoul and community-based preceptors, participated in the program. A needs-assessment survey was conducted among community-based preceptors before the workshop. Through this workshop, we derived learning objectives and a standardized curriculum for community-based medical education. RESULTS: In the questionnaire before the workshop, community-based preceptors voiced concerns over the program's potential costs and the time required for teaching. The learning objectives and educational programs derived from the workshop's consensus were consistent with the characteristics of the primary care. Based on the results of this workshop, the joint expert team developed a standard educational program on two core topics: clinical teaching and mentoring. CONCLUSION: From this curriculum development process, participants could construct a more standardized curriculum for community-based medical education. Future studies are needed to evaluate the long-term outcomes of these educational programs, such as the learners' satisfaction and achievement.

Association between Living Arrangements and Influenza Vaccination Rates among Elderly South Korean People: The Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-2) / 가정의학회지

BACKGROUND: This study aimed to investigate the association between living arrangements and influenza vaccination among elderly South Korean subjects. METHODS: We used data from the fifth Korean National Health and Nutrition Examination Survey. Participants older than 65 years were included and categorized into 4 groups according to the type of living arrangement as follows: (1) living alone group; (2) living with a spouse group; (3) living with offspring (without spouse) group; and (4) living with other family members group. A total of 1,435 participants were included in this cross-sectional analysis. RESULTS: A lower vaccination rate was observed in the living with offspring (without spouse) group, whereas the living with a spouse group had higher rates of both seasonal and H1N1 influenza vaccination. After adjusting for age, sex, region, education level, income level, and number of comorbidities, the living with offspring (without spouse) group had a higher H1N1 vaccination non-receipt rate than the living alone group (odds ratio, 2.03; 95% confidence interval, 1.08-3.82). CONCLUSION: Influenza vaccination rates differed according to the type of living arrangement. Particularly, those living with offspring (without spouse) had the lowest H1N1 influenza vaccination rate compared to those with other living arrangements, and this difference was significant. Interventions to improve influenza vaccination coverage should target not only elderly persons who live alone, but also those living with offspring.