Healthcare system in Korea was found to be very vulnerable to public health emergency preparedness and response as demonstrated in the recent outbreak of Middle East Respiratory Syndrome Coronavirus. We need to redefine the function of and improve the capability of local district public hospital and local health center to cope with potential threats by newly emerging infectious disease in the nearer future. While central government may be responsible for early detection of newly emerging infectious disease transmitted from outside of the country, local government and its district-level public healthcare agencies need to primarily control over spread of the disease among the local residents. Governance setting for rapid response required in public health crisis situation appears to be possible based on strong local public health infrastructure for health promotion and disease prevention at si-gun-gu district level. Proper and sustainable investment is also needed for local public hospital with high standard facilities and skilled healthcare manpower since there seems little economic incentives to maintain such facilities in private hospitals. In conclusion, it would be urgent task to improve prevention activities for infectious disease of local health centers and clinical activities of local public hospital. Especially, role and competencies of public health physicians working at the public health center need to be specified as an essential component of public health infrastructure.
Civil Defense ; Communicable Diseases ; Communicable Diseases, Emerging* ; Coronavirus ; Delivery of Health Care ; Disease Outbreaks ; Health Promotion ; Hospitals, Private ; Hospitals, Public* ; Investments ; Korea* ; Local Government ; Middle East* ; Motivation ; Public Health

BACKGROUND: This study was conducted to explore the prevalence of and the factors affecting constipation in elementary school students in urban and rural areas. METHODS: Study subjects were 585 grade 5 and 6 students. We conducted self-administered questionnaires during October, 2009. Outcome measure was the prevalence of constipation evaluated by the Rome III Diagnostic criteria for functional constipation. Independent variables were gender, grade, residence, mother's employment status, self-rated health status, number of family members, bowel movement habit, and health behavior (nutrition, exercise, and stress). RESULTS: The multiple logistic regression analysis showed that females, grade 5 students, those with working mothers, and those physically inactive reported having constipation significantly more often. CONCLUSIONS: Our study revealed that the female gender, increasing age, mother's employment status, and physical inactivity were risk factors for constipation in elementary school students. To improve bowel function in children, health education programs and school health promotion programs targeting healthy life habits should be implemented.
Child ; Constipation* ; Employment ; Female ; Health Behavior ; Health Education ; Humans ; Logistic Models ; Mothers ; Outcome Assessment (Health Care) ; Prevalence* ; Risk Factors ; School Health Services ; Surveys and Questionnaires

OBJECTIVES: This study was conducted to identify factors that affect medical service performance in rural health sub-centers and to develop a method to improve health sub-center performance that takes advantage of these insights. METHODS: This study included 1,242 South Korean health sub-centers that had been in operation at least since December 31, 2009 as units of analysis. After adjusting for population differences between areas, the performance of medical service among health sub-centers was analyzed according to medical services performed per person. We performed t-tests, ANOVA, Scheffe's tests and multiple regression analyses. RESULTS: The following were significant variables affecting the medical service performance of rural health sub-centers: number of hospitals and clinics, presence of community health practitioner posts, distance from health sub-centers to main public health centers, distance from health sub-centers to the nearest emergency medical facilities, and proportion of the local population aged 65 and over. In contrast, the proportion of the local population between ages 0-4 and the placement of public health doctors that had already completed their internship were not significant variables. CONCLUSIONS: The medical service performance of health sub-centers located in rural areas is significantly affected by local population and health care environment characteristics, and therefore, it is imperative to develop strategies to provide differentiated service based on these factors.
Aged ; Delivery of Health Care ; Emergencies ; Humans ; Imidazoles ; Internship and Residency ; Nitro Compounds ; Public Health ; Rural Health

OBJECTIVES: This study was conducted to find the relationship between oral health conditions of elderly people and closures of public dental health clinics in rural areas. METHODS: Oral examinations and surveys were conducted in 2011 from May 11 through November 4 on 383 seniors over 65-years and under 74 years old. RESULTS: The results of this study were as follows: 1. The results of comparative analysis of the usage behaviors of health clinics of subjects in relation to the closures of public dental clinics within the area showed that the usage level and frequency of public health agencies in areas with public dental clinics were high, and that the trend of influence on personal oral health conditions and improvement in prevention was high. When compared to 3 years ago, there was an 11.6 percentage point reduction in areas without public dental clinics (24.4%) compared to areas with public dental clinics (12.8%). 2. The results of comparative analysis of the oral health conditions and behaviors of subjects in relation to the closures of public dental clinics showed that the level of dental caries was high in areas with no public dental clinics, and the number of toothbrush usage and oral health supplemental product usage were shown to be high in areas with public dental clinics. CONCLUSION: The closures of public dental clinics were found to affect oral health behavior and conditions of elderly people in rural areas.
Aged* ; Dental Care for Aged ; Dental Caries ; Dental Clinics* ; Diagnosis, Oral ; Humans ; Oral Health* ; Public Health* ; Rural Health Services

OBJECTIVES: The purpose of this study was to determine the effect of public health facilities rebuilding on the hypertension control in the rural area. METHOD: 6 health centers and 59 health subcenters in some Chung-chung province was surveyed. And 29,503 patients were finally selected who had records of prescription about hypertension at list once in those health facilities from July 1th, 2005 to June 30th, 2006. Demographic variable of patients and whether medical doctor was a medical specialist or not, and whether the facilities were recently rebuilded or not was measured. RESULTS: The Overall control rate was 53.9%. Women had higher hypertension control rate than men. And 60s and 70s years old are had higher hypertension control rate than 40s and 80s years old. Patients who had been treated from medical specialist had higher hypertension control rate than general doctor. And patient who treated in rebuilded public health facilities had higher hypertension control rate. CONCLUSIONS: Rebuilding of public health facilities were related to increasing control rate of hypertensive patients.
Facility Design and Construction ; Female ; Health Facilities ; Humans ; Hypertension ; Male ; Prescriptions ; Public Health ; Rural Health Services ; Specialization

OBJECTIVES: This retrospective study is to identify related factors of treatment success of patients with tuberculosis at community health centers. METHODS: The subjects of this study were 1,417 patients with tuberculosis treated in 28 community health centers. The predictors of tuberculosis treatment success were analyzed in terms of 2 areas, which were characteristics of patients and health centers(TB control program). The characteristics of patients consist of 2 factors, such as demographic & diagnosis and treatment. The present conditions of health centers consist of 3 factors, location of centers, resources, and community activities. Data were analysed using chi-square-test and logistic regression methods. RESULTS: The significant differences between success group and failure group were sex(p=0.003), age(p=0.013), job(p=0.000), type of patients(p=0.001), past history(p=0.029), BCG injection(p=0.009), sputum culture examination(p=0.017), period of treatment(p=0.000), location of center(p=0.001), population per staff(p=0.015), FTE(p=0.027), education days of staff(p=0.005), BCG injection rate(p=0.001), case detection rate (p=0.003), and health education provision rate(p=0.044). Then these variables were analysed using logistic regression analysis. Significant positive factors of treatment success were occupation(95% CI:1.3-6.1), periods of treatment(95% CI:1.5-2.2), center in large city(95% CI:1.2-16.7), center in middle city(95% CI:2.1-24.3), job education related TB(95% CI:1.02-1.3), and BCG injection rate(95% CI:1.1-303.4). Significant negative factors of treatment success were male(95% CI:0.1-0.5) and treatment after default(95% CI:0.005-0.5). CONCLUSIONS: Tuberculosis is still one of serious diseases in Korea, because it causes highest mortality rate among OECD countries. This study may provide information to improve treatment effectiveness of tuberculosis at community health centers.
Community Health Centers ; Delivery of Health Care ; Diagnosis ; Education ; Health Education ; Humans ; Korea ; Logistic Models ; Mortality ; Mycobacterium bovis ; Public Health* ; Retrospective Studies ; Sputum ; Treatment Outcome ; Tuberculosis*

"The Supporting Program for Obstetric Care Underserved Areas (SPOU)" provides financial aids to rural community (or district) hospitals to reopen prenatal care and delivery services for regions without obstetrics and gynecology clinics or hospitals. The purpose of this study was to evaluate the early stage effect of the SPOU program. The proportion of the number of birth through SPOU was calculated by each region. Also survey was conducted to investigate the extent of overall satisfaction, elements of dissatisfaction, and suggestions for improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) used their community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was 8%; their satisfaction rates were high. Short distance and easy accessibility was the main reason among women choosing community (or district) hospital whereas the reasons of not selecting the community (or district) hospital were favor of the outside hospital's facility, system, and trust in the medical staffs. The SPOU seems to be currently effective at an early stage. However, to successfully implement this program, the government should make continuous efforts to recruit highly qualified medical staffs and improve medical facility and equipment.
Adult ; Delivery, Obstetric/economics/*utilization ; Female ; Hospitals ; Humans ; Pregnancy ; Prenatal Care/economics ; *Program Evaluation ; Republic of Korea ; Rural Population

OBJECTIVES: To identify the importance of preventing tuberculosis for HIV (Human Immunodeficiency Virus) infectees and to monitor their management of health, we investigated the proportion of HIV-TB (Tuberculosis) deaths among the HIV deaths and its related factors. METHODS: Data for HIV deaths from 2002 to 2010 was acquired from Statistics Korea, after which the HIV deaths were reclassified into HIV-TB deaths or other deaths according to the KCD (Korean Classification of Diseases). We analyzed the proportion of HIV-TB deaths among HIV disease deaths and the relationship between HIV-TB deaths and related variables such as sex, age, educational level, marital status, etc. RESULTS: There were 774 HIV deaths in South Korea between 2002 and 2010. TB was the main cause of death in 10.1% of all HIV deaths. The total proportion of HIV-TB deaths was 10.1% but its proportion reached 16.3% between 2005-2007 and then decreased to 4% in 2010. Also, the proportion of HIV-TB deaths was significantly high in the young age groups, but its proportion was significantly low in married groups and well educated groups (p<0.05). CONCLUSIONS: The result implies that the policy that takes care of HIV infectee regarding TB prevention has been getting systemized on a national scale. Also, HIV-TB deaths have been affected by social factors such as education and marriage status.
Cause of Death ; Classification ; Education ; Healthcare Disparities ; HIV* ; Humans ; Korea ; Marital Status ; Marriage ; Tuberculosis*

Underserved area is a region that has a lack of healthcare resources. In the context of Korea, however, there are not enough detailed criteria for underserved areas. In this study, we aimed to develop indicators for underserved area through Delphi technique. We systematically reviewed the existing measure of underserved area. Sixty indicators were extracted as candidates across four domains in secondary medical care. Four domains are demand, medical resource, quality of care, and health outcome. To develop indicator, two round Delphi survey was conducted among 15 professional experts such as professionals and public administrators. In conclusion, 2 final indicators (accessibility, medical utilization) was determined as an appropriate measure in order to designate underserved area for secondary medical services. Using our criteria from Delphi technique, 36 areas were found as underserved areas for the secondary medical care.
Administrative Personnel ; Delivery of Health Care ; Delphi Technique ; Humans ; Korea

PURPOSE: Feedback in medical education is as important as developing the curriculum and choosing the right method of instruction. This study measured three overarching areas: student satisfaction rates with academic feedback, the type and helpfulness of the feedback, and the types of feedback that students want. METHODS: In December 2013, 166 students answered a student survey that consisted of 26 items. The survey asked questions on their experiences with the overall feedback that was given the previous semester, the satisfaction rate, the type of feedback that was received, the helpfulness of the feedback, and the types of feedback that were desired after examinations and learning tasks. RESULTS: Overall, 35% of the students were satisfied with the feedback that they received in the previous semester. Students wanted more systematic (61.4%) and timely feedback (30.1%). The types of feedback that were most desired were "written comment feedback from the teacher" (51.8%) for learning tasks and "item difficulty, percentile ranks feedback" for examinations (62.0%). CONCLUSION: Students found the current feedback to be helpful, but the lack of feedback that students desired indicates that we must provide more systematic feedback in a more timely manner.
Curriculum ; Education, Medical ; Humans ; Learning ; Students, Medical*