RESUMO
Purpose@#The aim of this study was to show the association between the childbirth experience and life satisfaction among women with disabilities and estimate the moderating effect of family strengths and social support. @*Methods@#The target sample included disabled married women aged 20-49 years. We used the Disability and Life Dynamics Panel 2018. The total number of participants was 220. Three groups were defined based on the childbirth experience: women who had never given birth (13.6%), those who gave birth before the onset of disability (73.2%), and those who gave birth after the onset of disability (13.2%). We identified differences in general characteristics, family strengths, social support, and life satisfaction across the 3 groups and examined the moderating effect of family strengths and social support for the childbirth experience and life satisfaction. @*Results@#Women who gave birth after the onset of disability were in better health, exhibiting longer disability retention periods. The multiple regression analysis revealed that among women who gave birth after the onset of disability, life satisfaction was significantly higher than that of women without the childbirth experience because of the moderating effect of family strengths. However, social support had no significant effect on the childbirth experience and life satisfaction. @*Conclusion@#We empirically analyzed the status of childbirth before and after the onset of disability using representative survey data. The findings indicate a positive moderating effect of family strengths on the level of life satisfaction among women with disabilities.
RESUMO
Purpose@#The aim of this study was to determine the effect of visual impairment (VI) onset on the use of healthcare services across four types of institutions in South Korea. @*Materials and Methods@#We utilized data from the National Health Insurance Service database from 2006 to 2015 for 714 persons who experienced VI onset in 2009–2012 and for 2856 matched persons for a 1:4 ratio of matching controls. We compared trends in healthcare use and expenditures for eye diseases at clinics, hospitals, general hospitals, and tertiary teaching hospitals using 3 years of data prior to and after the onset of VI. @*Results@#The inpatient and outpatient healthcare expenditures of individuals with VI were higher than those without VI, peaking at the pre-VI onset period in tertiary teaching hospitals. During the pre-VI onset period, the proportion of healthcare expenditures attributed to eye diseases ranged 11%–40.8% among individuals with VI, but 1.9%–11% among individuals without VI at the four types of institutions. The differences in healthcare use between the pre- and post-VI periods were primarily observed in tertiary teaching hospitals for inpatient care. There was a peak in utilization of outpatient care in the year preceding VI onset at tertiary teaching hospitals, clinics, and hospitals, but there was a decrease in outpatient care over time during the post-VI period. @*Conclusion@#Our findings suggest economic burden of healthcare in tertiary teaching hospitals during pre-VI onset period and a potential lack of regular management and continuity of care in post-VI periods.
RESUMO
Purpose@#This study aimed to conduct a scoping review to understand how the coronavirus disease 2019 (COVID-19) pandemic has affected patients under infertility treatment. @*Methods@#The 5 steps of the scoping review by Arksey and O’Malley were applied: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; and (5) collating, summarizing, and reporting the results. Using 2 databases (PubMed and Cochrane Library), studies on COVID-19 and infertility treatment were searched, and 13 articles were selected for analysis. @*Results@#The studies were conducted in North America (5 articles), Europe (3 articles), Asia (2 articles), and other regions (3 articles). The academic fields of the published journals were primarily reproductive medicine (10 articles), followed by psychiatry and psychology (2 articles), and complementary medicine (1 article). Regarding the research topic, studies on stress and anxiety were the most common (7 articles), followed by pregnancy rates (3 articles), and pregnancy planning or treatment decisions (3 articles). The COVID-19 pandemic had a negative effect on stress and anxiety of patients in 5 out of 7 articles, no changes in pregnancy rates in 3 out of 3 articles, and negative effects on pregnancy planning or treatment decisions in 2 out of 3 articles. @*Conclusion@#The results of this review suggest that evidence-based information on patients with infertility is needed to prevent unnecessary anxiety, stress, and treatment delays in the upcoming postpandemic transition period.
RESUMO
Purpose@#Japan established the convalescent rehabilitation wards, corresponding to Korea's rehabilitation medical institutions, in 2000 and developed it into the present system through continuous revisions. This study sought to analyze the issues and tasks faced by Japan segregated by the period of revision of convalescent rehabilitation ward-related medical fee regulations, through a literature review and further aimed to explore the direction of development of domestic rehabilitation medical institutions. @*Methods@#Ten revisions of the medical fee regulations were classified into three stages based on quality evaluation: (1) the quantitative expansion stage (2000–2006); (2) quality evaluation introduction stage (2008–2014); and (3) quality evaluation maturity stage (2016– 2020). @*Results@#The following issues and tasks emerged: (1) For the quantitative expansion stage; insufficient rehabilitation within the ward, insufficient after-hour rehabilitation, insufficient connection with acute-stage hospitals and maintenance facilities, and the low ratio of specialists. (2) For the quality evaluation introduction stage; disparity in the manpower between institutions, the necessity of a 365-day rehabilitation system, avoidance of critical patients, and the problem that an increase in the amount of rehabilitation did not lead to a qualitative improvement. 3) For the quality evaluation maturity stage; cream-skimming issues in selecting patients, inappropriate evaluation of rehabilitation effects, and the necessity of follow-up measures after discharge. @*Conclusion@#It is worth referring to the established regulations in Japan, and concurrently it is necessary to strengthen the evaluation of the structures, processes, and results when operating and evaluating rehabilitation medical institutions in Korea taking into account the side effects that could be identified in Japan.
RESUMO
Background@#This study examined the effect of having a usual source of care on the degree of patient-centered communication among persons with disability. The role of the usual source of care has been emphasized to improve patient experience, especially for patients with complex health conditions. @*Methods@#This study used the 2017–2018 Korean Health Panel data, and the final study observations were 22,475 (20,806 people without disability and 1,669 people with disability). We applied generalized estimating equation model to show the effect of having a usual source of care on patient-centered communication, and subgroup analysis considering the types and severity of disabilities. @*Results@#Persons who have disabilities, compared with ones without it, significantly had more usual sources of care (32.4% vs. 24.6%). By type of disability, persons with mental (51.4%), internal organ (43.8%), visual (37%), and physical disabilities (31.6%) had more usual sources of care than hearing/speech (26.6%), and developmental disabilities (18.6%). The average score of patient-centered communication was higher among who had a usual sources of care (3.2 vs. 2.7), and the regression analysis showed that having a usual sources of care was positively associated with higher patient-centered communication score (β=0.476, p<0.05). However, the positive effects of usual sources of care was not observed among persons with severe hearing/speech, developmental, and mental disabilities. @*Conclusion@#This study showed that role of patient-centered communication was limited in persons with severe hearing/speech disabilities, developmental, and mental disabilities. The education programs and supports are needed to improve communication skills between medical staff and persons with specific types of disabilities.
RESUMO
BACKGROUND: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. METHODS: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). RESULTS: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. CONCLUSION: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.
Assuntos
Feminino , Humanos , Cognição , Seguro Saúde , Coreia (Geográfico) , Tempo de Internação , Assistência de Longa Duração , Programas Nacionais de SaúdeRESUMO
OBJECTIVE: The objective of this study was to evaluate the association of social support with health status and health behavior. METHODS: This study was conducted with 79 elderly people in Gunja-ri, Dongsan-myun, Chuncheon. We performed face to face interview which was composed of socio-demographic characteristics, social support, health status and health behavior. The association between social support and result variables was analysed by Chi-square test and logistic regression. We used SAS ver9.1 for statistic analysis. RESULTS: Mean age of the study population was 72.0+/-7.0, social support score was 14.3+/-4.7 with full marks of 20 and 36.25% of the total population were shown to have depression. When the social support score was changed, depression (p=0.0007) and physical exercise (p=0.0312) showed significant difference. The self-rated health status was significantly related to the relationship with family members (OR=0.25, 95% CI=0.07-0.95) and the quality of sleep was also significantly associated to the relationship with family members (OR=0.21, 95% CI=0.06-0.73). The physical exercise was done significantly less in the group 'without' close friends than in the group with 'many' close friends (OR=0.21, 95% CI=0.05-0.94) and the depression was significantly more in the group without community participation than in the group with community participation (OR=4.79, 95% CI=1.62-14.15). CONCLUSIONS: Through this study, we could conclude that the social support factors are associated with health status and health behavior. Therefore, to improve the health status of rural elderly, we need to approach to develop social support.