Background: Our Lady of Porziuncola Hospital, Inc. (OLPHI) and the City Government of Calbayog, Samar collaborated to operate a City Ward and other related indigent services. The program was called: "Kamanlalakbay sa Kalusugan". After initial years of operation, no formal evaluation has been conducted to assess if the program is doable and achieving its objectives. There is also a need to identify problems hindering its implementation-hence this research. Method: A descriptive study utilizing a goal-based evaluation of the program was conducted last February 1 to March 31, 2010. It looked into: how processes are implemented; if target beneficiaries were reached; contributions to include financial resources; and satisfaction of implementers and recipients to services rendered. It utilized census, logbooks, key informant interviews and pre-validated PSI questionnaires and quantitative and qualitative data starting from July 1, 2007 to December 31, 2009; with consent duly obtained from the respondents. Results: Subsidized operation of forty charity beds, transfer of city health services and LGU personnel in OLPHI, specialty missions, and tie-ups with service providers made health care accessible. Shared and outsourced assistance resulted to affordable care but financial subsudues are still deficient. Social service benefits, "in-kind/in-labor" payments, empowerment/capability building seminars, and community participation afforded active participation. Problems encountered included financial constraints; non-compliance to MOA; meddling from politicians/detractors and limitations as a new hospital. Conclusion: Public-Private partnership in health delivery is doable, offering a landmark innovation of giving accessible, affordable and actively participative care. However, obstacles identified were financial limitation and lack of continued support from implementers. The DOH-Eastern Visayas office will do follow-up program evaluation this year.
GOAL_BASED EVALUATION ; HEALTH CARE PROGRAM

PURPOSE: The study was conducted to clarify effects of a clonorchiasis prevention education program for clonorchiasis prevention lecturers. METHODS: The research adopted a single group pretest-posttest design to see effects of the educational program to prevent Clonorchis sinensis infection. The subjects of this study were 74 clonorchiasis prevention lecturers from primary health care facilities. The pretest was conducted before the clonorchiasis prevention education program and the post test was done after the 2-day program in August, 2011. Descriptive statistics, t-test, and ANOVA were conducted to analyze the data. RESULTS: The confidence level in Clonorchiasis management activities was improved significantly from 4.1+/-0.53 points before the education to 4.4+/-0.46 points after the education (t=-5.117, p<.001). The knowledge level about prevention of Clonorchis sinensis was improved significantly from 16.1+/-2.72 points before the education to 18.3+/-1.14 points after the education (t=-6.629, p<.001). CONCLUSION: The results suggest that the education program was effective in improving the confidence and knowledge levels in Clonorchiasis management activities for the clonorchiasis prevention lecturers. Based on the results of this study, continuous research on how the increased knowledge and confidence levels of Clonorchis sinensis prevention affect the prevalence of Clonorchis sinensis infection.
Clonorchiasis* ; Clonorchis sinensis ; Education* ; Prevalence ; Primary Health Care ; Program Evaluation

OBJECTIVES: Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. METHODS: This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. RESULTS: It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. CONCLUSIONS: To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions.
Delivery of Health Care ; Logic* ; Patient Safety ; Program Evaluation ; Quality of Health Care ; Telemedicine*

In Singapore, chronic care is provided by both ambulatory primary care clinics and specialist clinics in hospitals. In 2005, the National Healthcare Group (NHG) embarked to build a diabetes registry to enhance the continuity of care for patients with diabetes and facilitate greater efficiency in outcome measurement. This Chronic Disease Management System (CDMS) links administrative and key clinical data of patients with diabetes mellitus across the healthcare cluster. At the point of patient care, clinicians view a summary of each patient's chronic disease records, consolidated chart with physical parameters, laboratory investigation results and the "patient reminders" listing the clinical decision support prompts when key laboratory and screening tests are due for each patient. The CDMS provides reports of clinical outcomes in a systematic and efficient manner for quality improvement and evidenced-based population management. These include process indicators consisting of the rates of glycated haemoglobin (HbA1c), low-density lipoprotein-cholesterol (LDL-c) and nephropathy tests; and intermediate outcome indicators of the proportion of patients with poor HbA1c (>9%) and optimal LDL-c (<2.6 mmol/L) control. From January 2007 to December 2008, the rates of the 3 process indicators were relatively unchanged and that of HbA1c and LDL-c tests were high. There was gradual improvement in the proportion of patients achieving target level of LDL-c in both primary care clinics and hospitals. Fewer patients at primary care clinics had poorly-controlled HbA1c. As a tool for chronic care delivery, the NHG diabetes registry has made clinical monitoring and outcome management for patients with diabetes mellitus more efficient.
Diabetes Mellitus ; Humans ; Program Development ; Quality Indicators, Health Care ; Quality of Health Care ; Registries ; Singapore

PURPOSE: The purpose of this study was to analyze service occupation types and to develop training programs for the aged. METHODS: This study used descriptive study design. The research process consisted of three stages: first, identified the demand of service manpower for the aged; second, investigated present jobs and education programs in Korea and Japan; and last, developed service jobs and education programs for the aged. RESULTS: Potential users considered "health management" to be the most important area. They thought "providing job" as second most important. According to the result of analyzing Korean policies, there were 9 service occupations in 5 domains. So, we derived 10 occupations such as 'daily living manager', 'care manager', 'care worker', 'health manager', 'education specialist', 'leisure manager', 'good manager', 'housing manager', 'financial specialist' and 'retirement consultant' in 5 domains as healthcare, leisure, goods, housing and finance. Finally, we developed their tailored training programs. CONCLUSION: According to this study, there should be various occupations qualified by the government, and training programs should be settled. And healthcare providers must included in developing standardized training programs.
Busan ; Delivery of Health Care ; Education* ; Health Personnel ; Housing ; Humans ; Japan ; Korea ; Leisure Activities ; Occupations* ; Program Development

PURPOSE: The aim of this study was to evaluate the process and outcome of a mobile computerized system for individual home visiting healthcare. METHODS: A nonequivalent control group non-synchronized design was employed for this study. The newly constructed system was administered to 80 healthcare providers in the experimental group for 8 weeks. Data were analyzed using descriptive analysis, t-test, and ANCOVA with the SPSS 18.0 program. RESULTS: In the process stage, the difference in the frequency of computerized information usage between the experimental and control groups was significant as 8.88+/-3.20 and 7.08+/-2.92, respectively (t=3.90, p<.001). In the outcome evaluation stage, all kinds of healthy lifestyle such as alcohol use, nutrition, weight management and mental health were not improved. CONCLUSION: The findings of this study showed that the revised mobile computerized system was an effective device for individual visiting healthcare providers. Further advanced strategies for using this system should be developed and applied in a broad range of community healthcare.
Community Health Services ; Health Personnel ; Home Care Services ; House Calls ; Humans ; Life Style ; Mental Health ; Mobile Health Units ; Program Evaluation

This research was initiated as a preliminary work-up of information system development for primary health care delivery by community health practitioners in rural areas in Korea. The study was focused on the necessary information for enhancing the works of the community health practitioners and that required for health promotion and maintenance within the community. The data were obtained by a questionnaire survey from 458 community health practitioners who participated in computer related education from June 25th to September 26th, 2001. Only 288 (62.9%) of 458 responses were selected for evaluation due to incomplete returns. The majority(76.8%) of participants was using computer once a day at the healthcare centers and the duration of computer usage was more than one year in most cases. The primary usage of computer was for making documents, sending and receiving e-mails, and searching information on the internet. On the contrary, other skills and functions as data management, statistics, web development, games, program development, e-business, and searching for books and articles were not as readily utilized. The essential information for enhancing the performance of the community health practitioners appeared to be that related to drugs and diseases primarily. Other items for respondents in the decreasing order of importance were minimizing manual paper-works, computerized business, computer education, and media development and materials for health education, respectively. The overall information need of respondents was the highest on health and disease, and that on others such as health education, health promotion, elderly care, and fitness exercises were high also. In summary, the community health practitioners should have applicable information system to enhance their performance by obtaining necessary health maintenance and promotion information; by networking available resources; and by enabling them to adapt to rapidly changing policies and work environment. The outcome of this study may provide information elements necessary in development of Health Information Systems for community health practitioners.
Aged ; Commerce ; Surveys and Questionnaires ; Delivery of Health Care ; Education ; Electronic Mail ; Exercise ; Health Education ; Health Information Systems ; Health Promotion ; Humans ; Information Systems ; Internet ; Korea ; Primary Health Care ; Program Development

OBJECTIVES: The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality. METHODS: We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes. RESULTS: We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality. CONCLUSIONS: The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.
Dataset ; Delivery of Health Care ; Emergencies ; Female ; Health Impact Assessment ; Hospitals, Teaching ; Humans ; Insurance, Health ; Korea ; Mortality ; Myocardial Infarction ; Program Evaluation

PURPOSE: The purposes of this study were to identify the factors influencing service quality in nursing homes, and to develop an evaluation instrument for service quality. METHODS: A three-phase process was employed for the study. 1) The important factors to evaluate the service quality in nursing homes were identified through a literature review, panel discussion and focus group interview, 2) the evaluation instrument was developed, and 3) validity and reliability of the study instrument were tested by factor analysis, Pearson correlation coefficient, Cronbach's alpha and Cohen's Kappa. RESULTS: Factor analysis showed that the factors influencing service quality in nursing homes were healthcare, diet/assistance, therapy, environment and staff. To improve objectivity of the instrument, quantitative as well as qualitative evaluation approaches were adopted. The study instrument was developed with 30 items and showed acceptable construct validity. The criterion-related validity was a Pearson correlation coefficient of .85 in 151 care facilities. The internal consistency was Cronbach's alpha=.95. CONCLUSION: The instrument has acceptable validity and a high degree of reliability. Staff in nursing homes can continuously improve and manage their services using the results of the evaluation instrument.
Humans ; Interviews as Topic ; Nursing Evaluation Research ; *Nursing Homes/standards ; Program Development ; Quality of Health Care/*standards ; Questionnaires

PURPOSE: Health care professionals represent an immediately available resource to promote smoking cessation. However, the content in smoking cessation intervention courses in most institutions is insufficiently covered due to the limited number of class hours. The purpose of this study was to develop a comprehensive tobacco cessation-web-based, multimedia, educational program for a range of medical professionals. METHODS: Based on Jung's Teaching and Learning Structure Plan Model, a development process was proposed comprising four stages: (1) analysis, (2) planning, (3) production, and (4) operation/evaluation. The effectiveness of the program was tested using quasi-experimental design, and the participants in experimental group were required to complete the program. Changes in the level of knowledge and attitude were measured. RESULTS: The educational program developed includes nine topics and 26 sub-topics. A total of 180 storyboards, 15 videos, and 27 pictures were made. After the education, the level of knowledge was significantly increased in the experimental group. CONCLUSION: This web-based program can be recommended as a potential medium for health care professionals to use in counseling smoking cessation. The study findings also indicated that the program may be either offered as a teaching aid or utilized concurrently with lectures for students studying health care-related topics.
Counseling ; Delivery of Health Care ; Humans ; Leadership ; Learning ; Lectures ; Multimedia ; Program Development ; Smoke ; Smoking ; Smoking Cessation ; Tobacco