PURPOSE: This study was conducted to identify the factors affecting on unmet healthcare needs of married immigrant women, especially who are working in South Korea. METHODS: It is designed as a cross-sectional descriptive study. We analyzed data from 8,142 working married immigrant women to the ‘National Survey of Multicultural Families 2015.’ Based on Andersen's health behavior model, logistic regression was conducted to determine the predictors of unmet healthcare need. RESULTS: The prevalence of unmet healthcare needs among the subjects was 11.6%. In multivariate analysis, significant predictors of unmet needs included existence of preschooler, country of origin, period of residence in predisposing factors, monthly household income, helpful social relationship, social discrimination, Korean proficiency, working hour per week in enabling factors, and self-rated health, experience of grief or desperation in need factors. CONCLUSION: The association between labor-related factors and unmet healthcare needs of marriage immigrant women currently working was found from nationally representative sample. Support policies for immigrant women working more than legally defined hours and having preschooler should be supplemented to reduce unmet healthcare needs. In addition, eradicating discrimination in workplace, enlarging social relationship, and developing culturally competent nursing services tailored to health problems caused by labor are needed.
Causality ; Delivery of Health Care ; Discrimination (Psychology) ; Emigrants and Immigrants ; Family Characteristics ; Female ; Grief ; Health Behavior ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Korea ; Logistic Models ; Marriage ; Multivariate Analysis ; Nursing Services ; Prevalence ; Social Discrimination ; Women, Working

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.
Appointments and Schedules ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Public Policy ; Spinal Cord Injuries* ; Transportation

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.
Appointments and Schedules ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Public Policy ; Spinal Cord Injuries* ; Transportation

This paper proposes a media access control (MAC) layer design for wireless body area network (WBAN) systems. WBAN is a technology that targets for wireless networking of wearable and implantable body sensors which monitor vital body signs, such as heart-rate, body temperature, blood pressure, etc. It has been receiving attentions from international organizations, e. g. the Institute of Electrical and Electronics Engineers (IEEE), due to its capability of providing efficient healthcare services and clinical management. This paper reviews the standardization procedure of WBAN and summarizes the challenge of the MAC layer design. It also discusses the methods of improving power consumption performance, which is one of the major issues of WBAN systems.
Equipment Design ; Health Services Accessibility ; trends ; Healthcare Disparities ; Humans ; Monitoring, Physiologic ; instrumentation ; Telemedicine ; instrumentation ; Wireless Technology

The role of physicians in reducing health inequity has been regarded only partial and anecdotal by most policymakers. Clinicians, primary care physicians in particular, do not have sufficient opportunities to be engaged in activities dealing with health equity. However, physicians are playing a key role in providing health care and health-related programs, usually interwoven with inequities in health and health care utilization. As a result, a more active role for physicians must be identified under the scheme of a comprehensive strategy in combating inequity in health. From the perspective of mediating factors linking social determinants of health and inequitable outcomes in health and health care, health behaviors, access, and processes of care are identified as potential areas for physicians' engagement. 'Health equity capacity' is emphasized as a cross-cutting tool to empower physicians to address inequity in their clinical practices. More broadly, practicing physicians are able to support their colleagues and communities through diverse activities and participation: technical assistance, research and education, community involvement, and advocacy. Among them, raising awareness and changing perceptions are indicated as crucial factors facilitating physicians' contribution to minimizing inequity.
Clinical Competence ; Delivery of Health Care ; Health Behavior ; Health Status Disparities ; Healthcare Disparities ; Humans ; Negotiating ; Physicians, Primary Care ; Professional Role ; Socioeconomic Factors

OBJECTIVETo explore the situation of equity in health service delivery in the experimental region of new rural cooperative medical scheme (NRCMS).

METHODSA household questionnaire survey was conducted to 2112 residents in the experimental county of NRCMS in Yuexi county with a stratified-cluster sampling on the situation of health service delivery, from July 1-15,2005. Data was analyzed with Epi Info 6.04 and SPSS 11.0 software and indices as rate, ratio, Gini coefficient, concentration index (CI) and chi-square test etc.

RESULTSThere was no significante difference of the treatment-seeking rate during two weeks among five groups economic condition residents (chi2 = 5.52, P > 0.05) and the rates were 48.14 per thousand, 82.90 per thousand, 65.88 per thousand, 48.72 per thousand and 50.66 per thousand respectively with CI = -0.026. Similarly, the hospitalization rates were 59.08 per thousand, 67.36 per thousand, 51.76 per thousand, 58.97 per thousand and 52.86 per thousand respectively in the last year and the CI = - 0.017. But there was a significante difference of rates on chronic disease among the five groups of residents with different economic conditions in the last six months (chi2 = 18.42, P < 0.01) and the rates were 295.40 per thousand, 243.52 per thousand, 230.59 per thousand, 225.64 per thousand and 176.21 per thousand and the CI = -0.055. When income reduced, the prevalence had been increasing among residents. Meanwhile, the collection funds showed unfair in residents with various income and the compensating fund of new rural cooperative medical scheme had not reduced the gap between rich and poor.

CONCLUSIONThere was an unequity of medicine expenditure and compensating fund in residents with various income in the experimental region. The low income residents had a high health service need and the government should improve NRCMS greatly to change the situation.

China ; Data Collection ; Delivery of Health Care ; Health Expenditures ; Health Services Needs and Demand ; Healthcare Disparities ; Humans ; Income ; Rural Health Services ; economics ; utilization

PURPOSE: The aim was to present our experiences implementing a cultural diversity (CD) education program. METHODS: The authors held a 4-hour CD class for third-year medical students. The aim of the class was to facilitate students to realize and reflect on the importance of CD on healthcare delivery in Korea. The class was comprised of an orientation about CD in Korea, physicians and multicultural guests sharing their experiences with students, small group discussion, and Q&A panel with multicultural guests. Students provided written feedback for program evaluation. Authors classified their comments qualitatively. RESULTS: Students mostly responded positively to the class with a significant focus on interacting with the multicultural guests. Students realized the significance of CD in healthcare and reflected deeply on their discussion with the multicultural patients. Students needed more time to interact with multicultural guests from a greater range of cultures represented in Korea. Most did not need English interpretation. CONCLUSION: The aim of the class was achieved. Medical students' interaction with multicultural patients may promote the students' understanding and reflection about CD in health care.
Cultural Competency ; Cultural Diversity* ; Culturally Competent Care ; Delivery of Health Care ; Education ; Education, Medical, Undergraduate ; Healthcare Disparities ; Humans ; Korea ; Patient Safety ; Program Evaluation ; Students, Medical*

OBJECTIVES: The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated. METHODS: Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables. RESULTS: The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and self-rated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model. CONCLUSIONS: The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.
Chronic Disease ; Dataset ; Delivery of Health Care ; Education ; Employment ; Healthcare Disparities ; Insurance Coverage ; Korea ; Logistic Models ; Methods ; Needs Assessment ; Negotiating ; Socioeconomic Factors

Background: The enactment of the Universal Healthcare (UHC) Act affirms the commitment of the State to safeguard the health of all Filipinos. One of the objectives of the Act is to integrate the different local health systems at the provincial level in order to minimize fragmentation in the delivery of health services. This significant undertaking needs effective inter-sectoral collaborations of various stakeholders both at the local and national levels. Methods: A systematic review of literature was conducted to generate evidence-based policy tools. A roundtable discussion (RTD) was organized in collaboration with the Department of Health (DOH) to frame the current issues of the devolved health system and the anticipated challenges surrounding the integration to the provincial level. Policy discussion was guided by specific operational concerns put forth by the DOH such as the roles and functions of key local actors, organizational models, and metrics of integration. Results: Inputs in the proposed organogram for the province-level integrated health system and assessment tool for identifying readiness of provinces were discussed and agreed upon. Critical issues in the composition of the members of the Provincial Health Board (PHB) and the line of command among constituents were raised. Conclusion and Recommendations Eight consensus key policy recommendations have been identified. These could be translated into operational guidelines for the DOH, local government units (LGUs), and other related national government agencies (NGAs) in implementing the local health systems integration as prescribed in the UHC Act.
Health Care Reform ; Delivery of Health Care, Integrated ; Policy

OBJECTIVETo understand the current situation of maternal health care and the association between maternal health care and relevant factors.

METHODSAccording to a cross sectional study design, 1512 mothers having children under 3 years old were drawn under stratified random sampling method and interviewed at their households in 15 counties, Tibet Autonomous Region of China.

RESULTS77.6% of the pregnant women received at least one antenatal checkup with an average of 3.89 times while the rate of antenatal checkup over 5 times was 26.3%. The hospital delivery rate was 40.4% in this area. 83.9% of the women received education under the health care program during pregnancy and 66.2% of them were visited by health workers after delivery. Major factors of the antenatal checkups would include the resource of income, living in nomadic area, personal sanitation, antenatal health care education, mobilization of delivery at hospital, knowledge of antenatal health care etc.

CONCLUSIONSThere had been great improvement in women's health care in this area as compared with the status in 1999, but the frequency of receiving antenatal checkup was still not enough and the rate of hospital delivery was also low as compared with 46 counties in western areas of China. Poor knowledge of health care during pregnancy seemed to be the major factor that limited the utilization of antenatal health care. Knowledge on health and common sense of health care should be disseminated to improve the antenatal care and to enhance the hospital delivery rate.

Agriculture ; Cross-Sectional Studies ; Female ; Health Education ; statistics & numerical data ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Interviews as Topic ; Maternal Health Services ; statistics & numerical data ; Pregnancy ; Socioeconomic Factors ; Tibet ; Transients and Migrants