Service Demand for and Awareness of a Primary Healthcare Pilot Project for People With Disabilities

Kim Hye-Jin,Jang Soong-Nang,Lim Jae-Young 대한의학회 2022 Journal of Korean medical science Vol.37 No.30

Background: This study investigated the demand for and awareness of a primary healthcare pilot project for people with disabilities; it also sought to identify relevant determinants for demand and awareness using Andersen’s behavioral model of health service use. Methods: This study is a secondary analysis of data from the population-based survey conducted in Gyeonggi Regional Health & Medical Center for People with Disabilities. The data was designed with quota random sampling based on the population with disabilities in each district (city [si] and county [gun]) across the Gyeonggi province (do) to evaluate the health and healthcare accessibility of the disabled people living in the Gyeonggi province. The data was collected through the mobile-based survey of 1,140 people with disabilities living in Gyeonggi-do between March 2021 and June 2021. Results: Awareness of the service (12.1%) was remarkably low, while the demand (80.5%) was high. The gap between respondents who needed the service but were unaware of it differed according to age, education, activities of daily living, health information sources, chronic disease, depression, subjective health status, and unmet healthcare needs. Chronic disease (odds ratio [OR], 1.86; P = 0.001) and an unmet need for medical care (OR, 2.30; P = 0.002) had significant influences on demand for the service. Furthermore, living alone (OR, 0.42; P = 0.023), medical aid program beneficiary status (OR, 2.10; P = 0.020), access to health information from health service centers (OR, 4.00; P = 0.002), chronic disease (OR, 1.68; P = 0.043), severity of disability (OR, 1.78; P = 0.025), and subjective health status (OR, 4.51; P < 0.001) significantly affected awareness of the program. Conclusion: Chronic disease and an unmet need for medical care were key determinants of service demand, while the severity of disability was not. Thus, there is a need to review the initiative that defines service beneficiaries as people with severe disabilities. Policy makers should consider advertising programs to improve service awareness among people with disabilities.

The Implications of Digital Health Application on Eye Health - A Comparative Study between Egypt and Republic of Korea -

( Maria E. A. Mikhail ),( So Yoon Kim ) 미래의료인문사회과학회 2020 FUTURE MEDICINE & HUMANITIES Vol.3 No.2

Aim: This research aims to investigate the implications of Digital health application on eye health in two countries, Egypt and Republic of Korea. This has been done through studying the impact and the problems facing the two countries during Digital health application in the Ophthalmology and Public health fields and the proposed solutions. The purpose of this work is to reach a conclusion of future global applicable strategies of this new technology in the other countries by taking Egypt and Korea as a reference of application of it. Setting and Design: A Comparative retrospective study was conducted by collecting secondary data from the online articles, WHO reports and eye health initiatives reports and websites from the both countries to establish health profiles related to our topic of research for the two countries to learn from their experience for more global application of Digital eye health. Results: Egypt started two major teleophthalmology campaigns; Nour Al-Hayat and Eye health initiatives. While in Korea many new digital health technologies for improvement of the quality of life of patients with ocular diseases have been invented as LabSD, Ovitsz. The major problems of digital eye health application in Egypt were the fund, health illiteracy of digital health, and lack of clear database for eye health. On the other hand, in the Republic of Korea, teleophthalmology still prohibited by law, lack of trust of quality of services and the long acceptance process of any new digital eye health technology were the major problems. Conclusions: Digital Health is an important factor in improving eye health coverage. Both Egypt and South Korea started some serious steps towards digital eye health but still face problems of its broader application as lack of fund in Egypt and lack of trust in South Korea.

The Implications of Digital Health Application on Eye Health-A Comparative Study between Egypt and Republic of Korea

Maria E. A. Mikhail,So Yoon Kim 미래의료인문사회과학회 2021 FUTURE MEDICINE & HUMANITIES Vol.3 No.2

Aim: This research aims to investigate the implications of Digital health application on eye health in two countries, Egypt and Republic of Korea. This has been done through studying the impact and the problems facing the two countries during Digital health application in the Ophthalmology and Public health fields and the proposed solutions. The purpose of this work is to reach a conclusion of future global applicable strategies of this new technology in the other countries by taking Egypt and Korea as a reference of application of it. Setting and Design: A Comparative retrospective study was conducted by collecting secondary data from the online articles, WHO reports and eye health initiatives reports and websites from the both countries to establish health profiles related to our topic of research for the two countries to learn from their experience for more global application of Digital eye health. Results: Egypt started two major teleophthalmology campaigns; Nour Al-Hayat and Eye health initiatives. While in Korea many new digital health technologies for improvement of the quality of life of patients with ocular diseases have been invented as LabSD, Ovitsz. The major problems of digital eye health application in Egypt were the fund, health illiteracy of digital health, and lack of clear database for eye health. On the other hand, in the Republic of Korea, teleophthalmology still prohibited by law, lack of trust of quality of services and the long acceptance process of any new digital eye health technology were the major problems. Conclusions: Digital Health is an important factor in improving eye health coverage. Both Egypt and South Korea started some serious steps towards digital eye health but still face problems of its broader application as lack of fund in Egypt and lack of trust in South Korea.

탄자니아 다르에스살람시에 거주하는 장애아동의 기능상태 및 건강서비스 접근성 분석

전은영,하태희,오혜경 한국재활간호학회 2024 재활간호학회지 Vol.27 No.1

Purpose: This study aimed to evaluate the functional status and health service accessibility of the disabled children in Dar es Salaam, Tanzania. Methods: The research design for this study was a descriptive survey using convenience sampling using questionnaires. A total of 184 subjects were used to analysis. Data were analyzed using SPSS program version 22.0 to conduct independent t-tests, one-way ANOVA tests, x2 tests, and multiple regressions. Results: The disabled children had more difficulty accessing health services compared to those without any disabilities. Factors negatively influencing health service accessability were inadequate drugs or medical equipment (t=2.18, p=.031), inability to afford transportation(t=3.00, p=.003), and inability afford the medical costs (t=2.54, p=.012). Also, Mother’s anxiety (β=-.50, p<.001) and child’s education experience (β=.22, p=.029) were identified as the influencing factors on the barriers to health care services. The relevant variables showed 30.5% influence (F=16.60, p<.001) on the barriers to health care services in disabled children. Conclusion: The findings indicate that in order to enhance the disabled children‘s accessibility to health services, governmental support for transportation and medical costs are needed. In addition, it is necessary to promote the mental health of mothers raising children with disabilities.

장애인의 건강관련 삶의 질에 대한 사회적 결정요인의 영향

김현희,이동영 한국콘텐츠학회 2024 한국콘텐츠학회논문지 Vol.24 No.6

본 연구는 장애인 건강불평등의 결과지표로서 건강성과를 충실히 반영하고 있는 건강관련 삶의 질에 초점을 맞춰 이의 사회적 결정요인을 다차원적으로 접근하여 구조적 인과관계를 실증적으로 규명함으로써 장애인의 건강권 보장의 실효적 실천을 위한 단초를 제공하고자 하였다. 이를 위해 재가 장애인 420명을 대상으로 구조화된 설문지를 통해 자료를 확보하여 실증적 분석을 수행하였는바 연구모형은 Solar and Irwin이 제안한 건강의 사회적 결정요인 모형을 이론적 토대로 하여 설정하였다. 즉 환경요인, 행동요인, 심리사회요인을 주요 선행요인으로 적용하고, 의료접근성을 매개변인으로 하는 구조모형을 설정하여 구조방정식을 통해 분석하였다. 또한 구조요인으로서의 거주지역과 사회경제적 지위를 상황적 맥락의 조절변인으로 설정하여 인과모형상 경향의 조절효과를 다집단분석을 통해 검증하였다. 분석결과, 환경요인으로서의 주거환경의 질, 행동요인으로서의 건강증진행동, 심리사회요인으로서의 건강자기효능감은 모두 의료접근성 및 건강관련 삶의 질에 정(+)적인 영향을 미치는 것으로 확인되었고, 거주지역과 사회경제적 지위는 그 영향을 조절하는데 통계적으로 유의미함이 확인되었다. 이에 장애인의 건강관련 삶의 질 향상을 통한 건강불평등 해소를 위해 의료비지원 등의 단편적 지원을 넘어선 사회적 결정요인에 대한 체계적 관심과 개선이 요구됨을 전제로, 의료접근성의 조응적 고려와 지역별․사회경제적 지위별 편차 해소를 위한 의료자원 배분과 직조의 형평성 확보 노력에 대한 다양한 논의를 제언하였다. This study focuses on health-related quality of life, which faithfully reflects health outcomes as an outcome indicator of health inequalities for people with disabilities, and approaches its social determinants in a multidimensional manner to empirically identify structural causal relationships, thus improving the right to health of people with disabilities. The aim was to provide a starting point for effective practice of security. For this purpose, an empirical analysis was conducted by obtaining data through a structured questionnaire targeting 420 disabled people living at home. The research model was established based on the theoretical basis of the social determinants of health model proposed by Solar and Irwin. That is, environmental factors, behavioral factors, and psychosocial factors were applied as major antecedent factors, and a structural model with medical accessibility as a mediating variable was established and analyzed through structural equations modeling(SEM). In addition, residential area and socioeconomic status as structural factors were set as control variables of the situational context, and the moderating effect of the trend in the causal model was verified through multi-group analysis. As a result of the analysis, it was confirmed that the quality of the residential environment as an environmental factor, health protection behavior as a behavioral factor, and health self-efficacy as a psychosocial factor all have a positive influence on medical accessibility and health-related quality of life, and the residential area and socioeconomic status were confirmed to be statistically significant in controlling the impact. Based on these results, in order to resolve health inequality by improving the health-related quality of life of the disabled, systematic attention to and improvement in social determinants beyond fragmentary support such as medical expenses support is required, and harmonious consideration of medical accessibility and Various discussions were proposed on efforts to secure equity in medical resource distribution to resolve differences by region/socioeconomic status.

Access to Medical Services in Korean People With Spinal Cord Injury

김정길,Hyung Seok Nam,Byungkwan Hwang,Hyung-Ik Shin 대한재활의학회 2014 Annals of Rehabilitation Medicine Vol.38 No.2

Objective To investigate the accessibility of medical services for Korean people with spinal cord injury (SCI) compared to the control group (CG) and to evaluate significantly related factors.Methods A total of 363 community dwelling people with chronic SCI were enrolled and 1,089 age- and sex-matched subjects were randomly selected from the general population as the CG. Self-reported access to medical services was measured by asking “Have you experienced the need for a hospital visit in the last year but could not?”. This was followed up by asking the reasons for not receiving services when medically necessary. Variables, including lack of finances, difficulties making medical appointments, and lack of transportation were evaluated for accessibility to medical services.Results Sixty subjects (16.5%) in the SCI group had difficulties receiving medical services due to a lack of accessibility, compared to 45 (4.1%) in the CG (p<0.001). Variables causing difficulties receiving medical services were lack of transportation (27 persons, 45%), lack of finances (24 persons, 40%), and difficulty scheduling hospital appointments (9 persons, 15%) in the SCI group. In the CG, availability (lack of available time) and acceptability (deciding not to visit the hospital due to mild symptoms) were the reasons for not receiving medical care.Conclusion People with SCI experienced limited accessibility to medical services, which was due to environmental rather than personal factors compared to that in the CG. Therefore, development of social policies to reduce or remove environmental variables is necessary.

Healthcare access challenges facing six African refugee mothers in South Korea: a qualitative multiple-case study

Kim, Min Sun,Song, In Gyu,An, Ah Reum,Kim, Kyae Hyung,Sohn, Ji Hoon,Yang, Sei Won The Korean Pediatric Society 2017 Clinical and Experimental Pediatrics (CEP) Vol.60 No.5

Purpose: Following legal reform in 2013, the annual number of asylum seekers entering South Korea has increased from 1,143 in 2012 to 5,711 in 2015. We interviewed six African refugee mothers of young children regarding their health needs and barriers to access maternal child health services. Methods: We recruited mothers who had visited a clinic for immigrants between July 2013 and August 2015. Participants were African refugee women, aged over 18 years, who had given birth in Korea within the previous 5 years and had come to Korea over a year before recruitment. Interview questions examined participants' experiences in pregnancy and childbirth and concerns regarding their child's health status. Initial data analysis involved all researchers' immersion in the entire collection of transcripts. We then noted recurrent topics and themes and identified similar issues. Results: At the time of giving birth, 5 participants were asylum seekers and one had undocumented status. The following barriers impeded their access to maternal child healthcare: socioeconomic factors (unstable social identity, low economic status, difficulty obtaining health insurance), language barriers (lack of linguistically appropriate health information, limited access to translation services), and cultural barriers (religious and cultural differences). Weak social support also hindered access to healthcare soon after migration; however, social links with the community emerged as a key coping strategy following settlement. Conclusion: We identified barriers to maternal and child healthcare and coping strategies among African refugee mothers in Korea. Future research should assess refugees' health status and improve health access and literacy among refugee mothers.

Healthcare access challenges facing six African refugee mothers in South Korea: a qualitative multiple-case study

김민선,송인규,안아름,김계형,손지훈,양세원 대한소아청소년과학회 2017 Clinical and Experimental Pediatrics (CEP) Vol.60 No.5

Purpose: Following legal reform in 2013, the annual number of asylum seekers entering South Korea has increased from 1,143 in 2012 to 5,711 in 2015. We interviewed six African refugee mothers of young children regarding their health needs and barriers to access maternal child health services. Methods: We recruited mothers who had visited a clinic for immigrants between July 2013 and August 2015. Participants were African refugee women, aged over 18 years, who had given birth in Korea within the previous 5 years and had come to Korea over a year before recruitment. Interview questions examined participants’ experiences in pregnancy and childbirth and concerns regarding their child’s health status. Initial data analysis involved all researchers’ immersion in the entire collection of transcripts. We then noted recurrent topics and themes and identified similar issues. Results: At the time of giving birth, 5 participants were asylum seekers and one had undocumented status. The following barriers impeded their access to maternal child healthcare: socioeconomic factors (unstable social identity, low economic status, difficulty obtaining health insurance), language barriers (lack of linguistically appropriate health information, limited access to translation services), and cultural barriers (religious and cultural differences). Weak social support also hindered access to healthcare soon after migration; however, social links with the community emerged as a key coping strategy following settlement. Conclusion: We identified barriers to maternal and child healthcare and coping strategies among African refugee mothers in Korea. Future research should assess refugees’ health status and improve health access and literacy among refugee mothers.

한국 노동시장 불안정성과 미충족 치과의료의 관련성: 고용과 소득 불안정성을 중심으로

차선화 ( Xianhua Che ),박희정 ( Hee-jung Park ) 대한예방치과·구강보건학회 2018 大韓口腔保健學會誌 Vol.42 No.4

Objectives: The aim of this study was to analyze the accessibility of dental care services among individuals with precarious employment in South Korea. Methods: We used the 9th wave of the Korean Health Panel data (2015) and included 7,736 wage and non-wage earners in our study. We determined precariousness in the labor market as a combination of employment relationship and job income, and categorized individuals based on this into the following four groups: Group A comprising those who report job and income security, Group B comprising those who experience job insecurity alone, Group C comprising those who report a stable job but low income, and Group D comprising those who experience both job and income insecurity. Accessibility to dental care services was determined by experience of unmet dental care needs and unmet dental care needs caused primarily by financial burden. Logistic regression analyses were used to assess the effect of precarious work on access to dental care services. Results: Individuals with job insecurity (Group B; OR=1.445; 95% CI=1.22-1.70) and both job and income insecurity (Group D; OR=1.899; 95% CI=1.61-2.24) were more likely to have unmet needs than the comparison group. Both groups B and D were also 2.048 (95% CI=1.57-2.66) times and 4.435 (95% CI =3.46-5.68) times more likely, respectively, to have unmet dental care needs caused by financial burden. Education status, health insurance, and health status were all also effective factors influencing unmet dental care needs. Conclusions: Unstable employment and low income resulted in diminished access to dental care services. Therefore, governments should consider health policy solutions to reduce barriers preventing individuals with employment and income instability from accessing adequate dental care.

「장애인건강권법」으로 야기된 장애인스포츠지도사 관련 법률적 문제 연구

김지태,정태린 한국웰니스학회 2022 한국웰니스학회지 Vol.17 No.2

For humanity, health is one of important issues directly related to life. With this reason human rights to health are protected regardless of any reason and most of countries all around the world has defined the rights as essential to be protected in any form in their constitution or basic law. In particular, in the case of the disabled living with any types of permanent physical damage, more careful approach must be taken in secure the right of health. All processes such as diagnosis, prescription, treatment, and rehabilitation for the disabled are routine for them and are a matter of survival. In Korea, all processes of protecting the right to health of the disabled are permitted only to medical experts or sports and rehabilitation experts who are recognized by the Korean government or just certified as experts with such qualifications. The problem is that their role is enforce to be limited due to the Act of Health and Access to Medical Services for Persons With Disabilities, which was implemented to protect the right to health of the disabled. In this study, the purpose of this study was to investigate and analyze the facts that cause limitations in the role of sports instructors for the disabled in the Act of Health and Access to Medical Services for Persons With Disabilities, and to suggest ways to supplement the problems found in this process. The follow up legislative direction was proposed. 인간에게 건강은 생명과 직결되는 중요한 문제이다. 인간의 건강에 대한 권리는 어떠한 이유와 상관없이 보호받아야 하며, 이러한 이유로 각 나라에서는 어떠한 형태로든 헌법 내지는 기본법에서 필수적으로 보호받도록 정의하고 있다. 특히 영구적인 신체 손상을 안고 살아가는 장애인의 경우에는 건강권을 보호함에 있어서 더욱 조심해서 접근해야한다. 장애인은 진단, 처방, 치료, 재활 및 일상생활의 복귀를 목적으로 하는 재활까지 이루어지는 모든 과정이 그들에게는 일상이며, 중요한 문제이기 때문이다. 우리나라에서는 장애인의 건강권 보호를 실행하는 모든 과정은 국가에서 전문성을 인정하는 자에게만 역할을 허용하고 있으며, 장애인스포츠지도사는 그러한 자격을 가진 공인된 전문가라 할 수 있다. 문제는 장애인의 건강권 보호를 위해 시행된 장애인건강권법으로인해 이들의 역할이 한계를 가질 수 밖에 없다는데 있다. 이 연구에서는 장애인건강권법이 장애인스포츠지도사 역할의 한계를 야기하는 요소를 조사·분석하고, 이 과정에서 발견되는 문제점을 보완할 수 있는 방안을 제시하는데 그 목적을 두고 진행되었으며, 연구의 말미에는 후속 입법방향을 제안하였다.