Research in Community and Public Health Nursing

Jeong Myung Choi

7 Articles

The Effect of Copayment on Medical Aid Beneficiaries in Korea: Jin Joo Oh, Jeong Myung Choi, Hyun Joo Lee; J Korean Acad Community Health Nurs. 2015;26(1):11-17. Published online March 31, 2015; DOI: https://doi.org/10.12799/jkachn.2015.26.1.11

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PURPOSE
This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment.
METHODS
This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008.
RESULTS
There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001).
CONCLUSION
Copayment does not seem to be a great influencing factor on beneficiaries'accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.

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Impact of co-payment for outpatient utilization among Medical Aid beneficiaries in Korea: A 5-year time series study
Ki-Bong Yoo, Hong-Uk Ahn, Eun-Cheol Park, Tae Hyun Kim, Sun Jung Kim, Jeoung A Kwon, Sang Gyu Lee
Health Policy.2016; 120(8): 960. CrossRef

The Effects of the Designated Doctor System on the Health of Medical Aid Beneficiaries: Jeong Myung Choi, Jin Joo Oh; J Korean Acad Community Health Nurs. 2012;23(4):438-445. Published online December 31, 2012; DOI: https://doi.org/10.12799/jkachn.2012.23.4.438

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Abstract PDF

PURPOSE
Medical Aid Beneficiaries were surveyed to identify differences in health behaviors, adherence to drug regimen, and quality of life between those people in the Designated Doctor System and those who are not.
METHODS
A total of 1,327 study subjects were separated into three groups: those in the Designated Doctor System for 2 years, those in for 1 year, and those not in the system.
RESULTS
After the introduction of the Designated Doctor System, 55.8% and 67.9%, respectively, of the subjects in the Designated Doctor System complained of inconvenience in relation to hospital use and the patient referral process. Also, the rate of emergency room use or hospitalization guided by the Designated Doctor System was only 8.7% and 6.5%, respectively. There were no significant differences in health behaviors and adherence to drug regimens between those in the Designated Doctor System and those who are not.
CONCLUSION
This study was carried out early in the introduction of the system. Therefore, it is necessary to monitor the positive and negative effects of the Designated Doctor System for a full reflection of its impact.

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The Effect of Case Management Services for High-risk Medicaid Beneficiaries
Young Jin Ahn, Yun-Kyoung Choi
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(8): 5430. CrossRef
The Effects of the Designated Doctor System on Health Care Utilization of Medical Aid Beneficiaries with Chronic Diseases
Min Jung Kim, Young-Ha Cho, Nam Hee Park
Journal of Korean Academy of Community Health Nursing.2015; 26(3): 278. CrossRef
A Study on Influential Factors on Satisfaction with the Use of Medical Services by the Qualified Recipients of Medical Aid(focusing on the period after the introduction of the selected medical center system)
Jin-Woo Lee, Se-I Yang, Kwang-Hwan Kim
Journal of Digital Convergence.2014; 12(3): 289. CrossRef

A Study on the Development of a Database for a Health Care System: Focusing on Health Care Management for Hypertensive Patients and Middle-aged Women: Jeong Myung Choi, Hae Ja Lee, Chun Mi Kim; J Korean Acad Community Health Nurs. 2004;15(3):365-375. Published online September 30, 2004

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Abstract PDF: PURPOSE
This study intends to make a database for hypertensive patients and middle-aged women who are visiting the Yeojoo County Health Center. While building up the database, the study reviewed the current assessment tools used in the health center, developed appropriate health care programs, and designed a computerized health care system.
METHOD
The modeling of a database for the system was constructed by MS-Access for DBMS (Database Management System) and Visual Basic. The system is to be used only in the health center by being designed as a client-server method, making it possible for many public employees to be interconnected, and enables them to retrieve and search data from the database simul- taneously.
RESULTS
The health management system systematically follows nursing processes including assessment, diagnosis, intervention and evaluation. Diagnosis, once it is done according to the self-determined criteria, saves time and provides appropriate health information for the members. Also, the health education program was developed to follow up on the health status of the members on a continuous basis.
CONCLUSION
Based on these results, it is required to evaluate health care programs provided for the members by using the database system and to develop more practical health care programs. It is also necessary to connect the system to other databases, which contain information about members.

Family Functions Characterized by the Industrial Accident Disabled: Jeong Myung Choi, Jin Joo Oh, Hye Jin Hyun, Hyun Joo Lee, Soon Nyung Yoon; J Korean Acad Community Health Nurs. 2003;14(3):488-495. Published online September 30, 2003

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Abstract PDF: PURPOSE
This study was attempted to provide the basic data in order to develop a supportive system for the family by investigation of the general and disability-related features of the industrial accident disabled and their family function.
METHOD
Three hundred and forty six industrial accident disabled were randomly selected among those who resided in the Seoul, Incheon, and Gyeonggi areas, and who were confirmed as disabled according to its severity from the first to fourteenth grade from January, 1998 to December, 2000. The data were collected for one month from August 1 to August 31, 2001. Each study team consisted of two members out of 20 researchers and they interviewed the disabled individually by visiting their homes. Collected data were analyzed using frequency, percentages, t-test, ANOVA, and Correlation, etc.
RESULTS
The average score for family function was 102.60. The adaptability represented the highest score among the concepts dependent on the family function. The concepts were cohesion, adaptability and communication, which scored as 33.59, 35.38, 33.34, respectively. The family function was significantly different in education, marital status and subjective health status. In particular, the family function was excellent from the industrial accident disabled who had graduated from middle school, was married, and felt healthy. Depression and quality of life were other factors, which were also correlated significantly with the family function. The lower the degree of depression and the better the quality of life, the better the family function.
CONCLUSION
The industrial accident disabled who had been in poor health or faced with difficulties in daily activities even after the therapy for the disability was completed. In particular, their family always had a great burden to care for the disabled and to take financial responsibility. Therefore, the rehabilitation program for the disabled should be family oriented.

The Use and Needs on Community Rehabilitation Service of Industrial Accident Victims at Home: Jin Joo Oh, Hyun Joo Lee, Jeong Myung Choi, Hye Jin Hyun, Soon Nyung Yoon; J Korean Acad Community Health Nurs. 2003;14(2):179-189. Published online June 30, 2003

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Abstract PDF: OBJECTIVES
This study described the features of home-bound industrial accident victims and their needs for rehabilitation services. This study was also aimed to find a future direction of development of community rehabilitation programs that are suitable for their needs and demands.
METHODS
This study is a descriptive study. Data were collected through two phases using structured questionnaire. In the first stage, surveys were performed via telephone interviews. In the second stage, surveys were performed via home visiting. Subjects in the first stage included 2203 industrial injured victims staying at home, of whom, 368 individuals complaining of post-traumatic complications became the subjects of the second stage.
RESULTS
This study showed that the home-bound industrial accident patients were complaining of complications from the injury even after receiving treatment by IACI. However, they were neglecting their health problems without any intervention. Even if they use health care services, the treatment is mainly focused on acute medical care, which may not effective for them. Furthermore, they had unstable employment status and suffered from financial burden for health care costs. The Labor Welfare Organization has established a plan to remove barriers of industrial accident victims in reinstatement, and has been preparing various programs in order to establish an all-embracing service system for industrial accident victims from accident occurrence to reinstatement. However, these rehabilitation services can be truly helpful only when the injured are able to obtain enough information about them. The current restrictive system is also not appropriate for solving health problems of the industrial accident victims. Therefore, it is necessary to develop a plan that can provide industrial accident victims high-quality rehabilitation services so that they can use those services in the community without being dependent on hospitals. This study proposes visit nursing services as a way to provide various health services within community for the industrial accident victims.

Health Problems of Female workers in Small Workplace: Young Im Kim, Soon Nyung Yun, Jeong Myung Choi, Chun Mi Kim, Hye Sun Jung; J Korean Acad Community Health Nurs. 2000;11(1):117-126. Published online June 30, 2000

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Abstract PDF: For basic data to develop health management program of female workers. this study was intended to characterize factors affecting health problems of women at workplace which has less than 50 workers by Cornell Medical Index(CMI). 195 items of CMI questionnaire were simplified to 57 items which were composed of 35 items concerning physical health problems and 22 items concerning mental health problems. The data was collected during 6 months from July 10 to December 30 and analyzed with frequency, percentage, t-test and ANOVA. The 107 female workers included in this study was characterized to be mainly twenties(64.5%), single(69.2%) and working at production position(89.7%). The most frequent physical problem was fatigability and the next, neurological system and cardiovascular system. Main mental complaints were inadquacy. anger and tension. When the health problems were reviewed according to its general characteristics, anger in young age, adaptiveness in single and respiratory complaints in self-recognized unhealthy group were prevalent. According to life styles. the prevalent complaints were musculoskeletal one in alcoholic group and cardiovascular one in group who are sleeping just for four to five hours. The appropriateness of each items of CMI should be evaluated to reveal the reasons why meaningful results could not come from many items of this questionnaire. The repeated study should be carried out to figure out the health problems and its related factors of female workers at small scale workplace. Also, exercise program and abstinence from drinking and smoking should be carried out for female worker's health.

Community Health Practitioner's Commitment into Community : on the Aspect of Primary Health Care: Soon Nyoung Yun, Young Im Kim, Jeong Myung Choi; J Korean Acad Community Health Nurs. 1995;6(2):173-182. Published online December 31, 1995

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Abstract PDF: Primary health care(PHC) has been established since A Health Law for rural residents has been legislated in 1980 following the WHO declaration, "Health for All 2000". in 1978. PHC services are presently assumed to be provided by 2038 Community Health Practitioners(CHP) to about 28% out of rural population in Korea. Most CHPs have confronted the adaptation process to the community being practiced although a CHP's role is to evoke community participation for the improvement of their health by themselves. So the purpose of this study is to describe and explain of the commitment of CHPs into the community. Data were collected by direct interview and tape-recording under subjects' permission till theoretical saturation were occured from 6 CHPs. The subjects were 41 years old and have served in the community for 9 years in average. Main questions and concepts were explored from data according to the procedure of the grounded theory methodology. The results are as follows. 1) The number of the main concepts were twenty four that identified Motive, Desire, Personal characteristics, Unfamiliarity, Denial, Feeling of isolation, Self-sacrifice, Kindness, Patience, Assimilation, Respect for the residents, Support by the family, Support by the residents, Achievement, Acceptance of realities, Use of resources, Inducement of cooperation from the residents, Changes of the difference from time orientation between CHP and residents, Attitude as a official, Technical support, Cost management, Satisfaction level, Acknowledgement by the residents and discrepancy. 2) The twenty four concepts were categorized to seven groups such as Motivation, Feeling of Heterogeneity, Self-discipline, Social support, Induced changes in the attitudes of residents, Familarity and Persistent discrepancy. 3) The categorized groups were analyzed on the base of the Causal Conditions, Central Phenomena, Contexts, Intervening Conditions, Action / Interaction Strategies, and Consequences. Central phenomenon in this study was identified to be the feeling of heterogeneity. Community health practitioners experienced unfamiliarity and denial from the community and felt themselves isolated in the first. In time, they won the trust of residents by their efforts including self-sacrifice, kindness, patience, and assimilation. Afterward, practitioners got self-confidence and familiarity with lesser feeling of heterogeneity. Community health practitioners experienced unfamiliarity and denial from the community and felt themselves isolated in the first. In time, they won the trust of residents by their efforts including self-sacrifice, kindness, patience, and assimilation. Afterward, practitioners got self-confidence and familiarity with lesser feeling of heterogeneity. Nevertheless, practitioners could not commit themselves completely because of the persistent discrepancy between CHP and residents. 4) On the commitment process, the CHPs' feeling of heterogeneity were decresed and social support increesed and newly evolved induced change of residents through the continuous interaction between CHP and them. The contribution of this study would be concluded as follows. The contribution of this study would be concluded as follows. 1) It is expected that effective strategies for more rapid committment into the community can be developed based on this study. 2) More easy committment would be possible for the newly appointed CHP through understanding of the committment process identified on this study.

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