A Study on Characteristics of Core Projects Described in 3rd Community Health Plans / 예방의학회지

OBJECTIVE: The 3rd community health plan let health centers select and promote core projects considering budget and manpower. This study analyzed the content and selection processes of core projects, using the nationwide 3rd community health plans, to give relevant information on health center policies. METHODS: Classification criteria for content analysis of core projects were established and verified through a literature review and by specialist discussions. Fifty plans were selected by stratified proportional random sampling for regional characteristics. And coding criteria standardized through coding repetition and discussion, by 2 persons (k> 0.7). Using stratified proportional random sampling for 16 cities and provinces, regional characteristics, 117 plans were selected, and the contents of the core project selection processes and program contents analyzed. RESULTS: The survey was used by 59.8 % of samples as a core project decision-making method. The participants included 98.6, 81.4, 40 and 38.6% of the health staffs, residents, medical institutions, and administrators, respectively. Discussion was used by 15.4% of samples. The participants were health staffs by 100% as a great. The ranking of the frequencies of the selected core projects were, in order; chronic disease control, health promotion, elderly health, maternal-child health, and oral health at 16.4, 14.8, 14.3, 12.7 and 11.9%, respectively. Analyses on the chronic disease control and elderly health contents showed the diversity of object disease, high rates of visitors on patient detection programs, high rates of unclear target populations, and the provision of medical exams and treatments as the main services, with high variations in business per-formance. The national health budgets for health centers in 2003 were about 910 and 240 million won for chronic disease control and elderly health, respectively, which were less than for the other five priority core projects. CONCLUSION: The chronic disease control and elderly health at the health centers were not standardized for object disease, patient detection program, target population, service provision, and national support budget was insufficient. Thus it is necessary to develop standard guidelines, and increase financial support, for chronic disease control and elderly health.

Time series analysis on outcomes of tuberculosis control and prevention program between small areas in Korea : with patient / 결핵

BACKGROUNDS: Today, tuberculosis cannot only be cured medically, but also controlled by public health. Despite the overall worldwide decline in tuberculosis, the disease continues to be a significant problem among developing countries and in the slums of large cities in some industrialized countries. Particularly, this communicable disease has come into the public health spotlight because of its resurgence in the 1990's Our country has been operating the Korean National Tuberculosis Control Program since 1962, focusing around public health centers. Therefore, this study aims to compare the effectiveness of tuberculosis control activities, one of the major public health activities in Korea, by producing indexes, such as the yearly registration rate per 100,000 population and treatment compliance of tuberculosis on in small areas (communities). METHODS: This work was accomplished by constructing a time-series analytic model using data from "1980~2000 : the Yearly Statistical Report" with patient registry data of 234 City. County. District public health centers and by identifying the factors influencing the tuberculosis indexes. RESULTS: The trends of pulmonary tuberculosis positive point prevalence and pulmonary tuberculosis negative point prevalence on X-ray screening have declined steadily, beginning in 1981 and continuing to 1998 by region (city. county. district). Although the tuberculosis mortality rate steadily shows a declining trend by year and region, but Korea still ranks first among 29 OECD countries in 1998, with a tuberculosis mortality rate of 7.1 per 100,000 persons, according to the time-series analysis for fatal diseases. CONCLUSION: The results of the study will form the fundamental basis of future health care planning and the Korean Tuberculosis Surveillance System on 2000. Since the implementation of local autonomy through the Local Health Act of 1995. it has now become vital for each city. county. district public health centers to determine its own priorities for relevant health care management, including budget allocation and program goals.

The Possibility of Regional Health Insurance Data in Blueprinting the Local Community Health Plan / 예방의학회지

The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. Frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.