PURPOSE This study examined the effects of case management (CM) for Medicaid on healthcare utilization considering the Medicaid system. METHODS Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare the effects on healthcare utilization between the CM group and the non-CM group. The subjects were 535 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006. RESULTS The outpatient days and medication days of the CM group decreased significantly more than those of the non-CM group with the copayment system. There were no significant differences of healthcare utilization between the CM group and the non-CM group with the designated doctor system. CONCLUSION CM worked effectively on Medicaid beneficiaries' outpatient healthcare utilization with the copayment system. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, future studies are needed to develop strategies to reduce hospitalization and Medicaid beneficiaries' outpatient healthcare utilization with the designated doctor system.
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PURPOSE The purpose of this study was to compare functional status and the level of health care needs in elderly Koreans in health care institutions. METHODS Data were collected from 2,521 elderly patients admitted in 50 health care institutions (hospitals, oriental hospitals, geriatric hospitals, and health care facilities) selected through proportional stratified sampling in 2008. We used a long-term care (LTC) assessment tool developed by the government, which consists of 52 items with 5 subscales. RESULTS Statistically significant differences were detected in functional status and the level of health care needs among the subjects in different health care institutions. Of the sample population in geriatric hospitals, 48.9% were eligible for LTC Category 1, 20.9% for Category 2, and 17.2% for Category 3, and 13.1% of the subjects were not eligible for any of the categories. Of the sample population in health care facilities, 29.9% were eligible for LTC Category 1, 20.5% for Category 2, and 21.8% for Category 3, and 27.0% of the subjects were not eligible for any of the categories. CONCLUSION The findings of this study indicate the necessity of the development of an evaluation system that helps determine whether a subject is eligible for LTC.
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PURPOSE The purpose of this study was to describe and understand elementary school health teachers' role perception in their own perspectives. METHODS Data were collected from three focus groups composed of five participants for each group. Each focus group had an interview for two and a half hours on the average. The main question was "What is your perception on the roles of health teachers in elementary schools?" Qualitative data from transcribed notes and field notes were analyzed using qualitative content analysis. RESULTS Five main roles were identified from the participants. The participants perceived themselves as 'an expert of health education in school and community', 'a health service provider for school members', 'a health guardian for school members', 'the coordinator of healthcare related works in school', and 'the leader of school health'. CONCLUSION The participants have multiple role identities, which are very important for health management of school members. And the roles such as an expert of health education and a leader for school health are recently emphasized. The findings of this study can provide useful information to design orientation programs for newly appointed health teachers and continuing education programs for enhancing role performance of health teachers in elementary schools.
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PURPOSE The purpose of this study was to measure the effects of a school safety education program based on the PRECEDE-PROCEED model for upper grade elementary students. METHODS One hundred ten 6th-grade students sampled from an elementary school in D City were divided into the education group (n=55) and the non-education group (n=55). School safety education was provided to the education group for 8 weeks and a questionnaire survey about safety knowledge, safety practice and the frequency of safety negligence was carried out before and after the education from March 2 to July 13, 2010. RESULTS After the application of the safety education program, the education group got a higher safety knowledge score than the non-education group (p<.001). Both the education and non-education groups showed a significantly increased safety practice score (p<.01). In the comparison of safety negligence, the education group showed lower frequency (p<.01). In addition, according to the results of ANCOVA and t-test, the school safety education program influenced safety knowledge significantly (p<.001). CONCLUSION This result shows that a school safety education program based on PRECEDE-PROCEED can improve safety knowledge. Further studies will be required to develop continuous and systematic safety education programs.
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PURPOSE This study was descriptive survey research to examine the factors affecting menopause, depression and menopausal symptoms, and the relations among these factors in South Korean midlife women. METHODS The subjects were 319 midlife women in Daegu City. Measures were Zung's Self-Report Depression Scale (1979) to check depression, and the Midlife Women's Symptom Index developed by Im (2006) to check menopausal symptoms. Data were collected from June 1 to July 31, 2010. Collected data were analyzed by mean, standard deviation, and Pearson's correlation coefficient through SPSS/WIN 18.0. RESULTS There was a statistically significant correlation between depression and menopausal symptoms (r=.692, p<.001). The factors affecting depression were age (r=.194, p<.001), income (r=-.307, p<.001), exercise (r=-.602, p<.001), and menopausal status (r=.224, p<.001). The factors affecting menopausal symptoms were exercise (r=-.158, p<.037), menstrual pain (r=-.171, p=.004) and menopausal status (r=.222, p<.001). CONCLUSION Intervention programs for decreasing menopausal symptoms in midlife women should be focused on relieving menopausal pain and encouraging excise from youth. Further studies will be needed to examine the relations among other factors including living style, area and menopausal symptoms.
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PURPOSE This study attempted to identify differences in elders' health status, quality of life, and satisfaction with customized home visiting health service depending on connection to volunteerism. METHODS A total of 400 subjects participated in this research. Data were collected from May to August of 2009 and the measurement tool used for this study was the house visiting health service recording sheet recommended by the Ministry of Health. RESULTS According to the results of this research on elders' health status in customized home visiting health service depending on connection to volunteerism, elders connected to volunteerism positively showed a high level in functional health status areas such as daily life performance ability, instrumental daily life performance ability and Joint exercise capacity, and in the quality of life area. CONCLUSION The results of this study can be utilized as complementary information when resources and networks are used for the effective management of house visiting health service subjects.
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PURPOSE The purpose of this study was to investigate the influencing factors of influenza vaccination in the elderly participating in lifetime transitional health examination. METHODS This study was a secondary analysis of data collected from lifetime transitional health examination (for 66-year-old people) conducted by the National Health Insurance Corporation (NHIC) from January 1 to December 31, 2008. Questionnaires were received from NHIC to obtain information regarding gender, chronic diseases, health-related behaviors, and ADL. A total of 255,333 participants who responded all the questions in the questionnaire were included in the analysis. Collected data were analyzed by descriptive statistics, chi2 test, and multiple logistic regression. RESULTS The influenza vaccine coverage rate in 66-year-old people was 66.1%. The influenza vaccine coverage rate was higher in female elders and those with hypertension, diabetes, heart disease or past smoking, and lower in those with stroke, current smoking, drinking, no-exercise or ADL-dependency. CONCLUSION Strategies for improving the influenza vaccination coverage rate in the elderly are needed. The strategies should give priority to the elderly with current smoking, drinking, and no-exercise, and home visiting programs are needed for the elderly with stroke and ADL-dependency.
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PURPOSE The purpose of this study was to examine the effects of knowledge about the harmfulness of smoking and attitude toward smoking temptation for middle school students. METHODS A survey was conducted in this study on 745 students from 12 middle schools in the Y City. Data were analyzed with SPSS/WIN 12.0 using descriptive statistics, t-test, ANCOVA, Scheffe's test and multiple regression analysis. RESULTS There was statistically significant difference in knowledge about the harmfulness of smoking (F=2.88, p<.05) and attitude toward smoking (F=54.61, p<.001). And there was statistically significant difference in smoking temptations among tempting factors such as negative mood of individual (F=63.61, p<.001), positive mood of social situation (F=67.08, p<.001), habitualness (F=57.68, p<.001), weight control (F=33.01, p<.001), and others' smoking (F=73.13, p<.001). CONCLUSION These results suggest that smoking-cessation programs to enhance the effectiveness of nursing interventions should be tailored to the level of smoking temptation and that educational programs should be developed for middle school students.
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