Background: In this study, with the aim of improving the quality of transitional care service for discharged patients, the Health Care Quality and Outcomes Indicators of the Organization for Economic Co-operation and Development and National Health Service Outcomes Framework of the UK were applied to derive service items for provision and develop evaluation indicators under categories of effectiveness, safety, and patient-centeredness.Method: A scoping review was conducted to derive core concepts and evidence materials/data for transitional care service. For the derived items of transitional care service and evaluation indicators, a three-round Delphi study was conducted with experts in the fields of healthcare/ medicineursing/social welfare. Results: First, as a result of the scoping review, components of transitional care service (assessment of need by period of transitional care service, multi-professional team, connection to community resources, etc.) and themes for outcome indicators (effectiveness, patient safety, patient-centeredness) were derived. Second, by classifying the items for assessment according to the hospitalization and transition period and conducting a Delphi study to derive service items for transitional care service, during the hospitalization period, presence/absence of a caregiver and need for a caregiver, activities of daily living, and necessity for home-based care services were identified as items of high priority. Regarding patient safety, risk of falls and fractures during hospitalization, and necessity for medication reconciliation were identified as the items of high importance. For the transition period, provision of education regarding adequate responses and handling of emergencies, provision of information and guidance on application of services for basic livelihood security program beneficiaries, and education for patient skills in self-management of health were derived as items of high priority. Third, for the derivation of outcome indicators for transitional care service, in the “effectiveness” category, the experts rated a reduction in the 30-day readmission rate as an item of high importance along with a decrease in emergency department visits, reduction in preventable admissions as indicators of high relevance. In terms of “patient safety,” a decrease in drug adverse reactions, and reduction in the incidence of falls and pressure ulcers were identified as indicators of high priority. Finally, for the category of “patient-centeredness,” patient experience assessment, level of service satisfaction reported by patients and their caregivers, and reducing burden on caregivers were identified as indicators of high priority. Conclusion This study suggest practical implications for the service with high relevance and necessity for transitional period. It also presented outcome indicators of transitional care service to contribute toward an improvement in the quality of care.

OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Objectives: The purpose of this study is to investigate changes in public health-related perceptions of residents of Gangwon province after the outbreak of Coronavirus disease-19(COVID-19) of the public. Methods: We performed paired T-test analysis to measure the change in public health-related perceptions before and after COVID-19. We also utilized generalized estimating equations to identify demographic factors correlated with public health-related perceptions. Results: The public perceived public health as ‘All citizens can use medical care and protect/promote health.’ The concept was the most popular, from 94.3% in 2019 to 95.5% in 2020. In addition, after COVID-19, residents of Gangwon province's satisfaction with medical services increased, but the overall level was not high. Among the eight essential healthcare needs after COVID-19, cardiovascular disease and injury services have emerged as preferred services. However, by sociodemographic factors, distinctive responses were detected. Conclusions Through COVID-19, Gangwon residents' awareness of the public's health rights has increased. Those living in vulnerable areas or with unmet medical care, supported strengthening public health care. In addition, although medical satisfaction has increased, it is not satisfied, so listening to the voices of the population group with low satisfaction is essential. Lastly, since the necessity of essential health care may change due to specific events, the local government needs to plan health projects reflecting the needs of residents. Therefore, when designing the public health care strategy in Gangwon province, the local government should consider not only political factors but also environmental factors, demographic and conceptual factors.

Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea’s circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service’s Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.

목적: 병원에서 재가 및 시설로 퇴원한 환자가 지역사회에서 건강을 유지하기 위해서는 전환기 돌봄 서비스(Transitional care services)가 필요하다. 이를 위해 지역사회 내 의료서비스와 자원을 연계하는 주치의의 역할이 중요시된다. 본 연구에서는 선행연구를 바탕으로 일차진료 의사들의 환자중심성에 대한 인식을 파악하여 환자중심 기반의 서비스 제공을 위해 필요한 정책을 제시하였다. 또한 Transitional Care Service에 대한 일차진료 의사들의 인식을 확인하고 인구사회학적 요인과의 관계를 확인함으로써 서비스 우선순위를 도출하고자 하였다.방법: 본 연구는 전국의 가정의학과, 내과, 신경과 등 노인 질환과 관련 있는 과의 전문의 자격증이 있으며 자발적으로 온라인 설문조사에 참여할 의사를 표현한 일차진료 의사 259명을 대상으로 수행 되었다. 환자중심성 및 전환기 돌봄서비스에 대한 인식을 살펴보기 위해 구조화된 설문지를 개발하였 으며, 조사전문업체를 통해 2019년 10월 28일부터 2019년 11월 22일까지 온라인으로 설문조사를 수행 하였다.결과: 본 연구에 대한 주요 결과는 다음과 같다. 첫째, 일차진료 의사들을 대상으로 9가지 전환기 돌봄서비스 인식에 대해 살펴본 결과 “입원 시 진단, 건강상태, 치료계획 및 결과 에 대한 설명 (4.4)”과 “퇴원 후 자가 건강관리를 위한 정보 및 훈련 (4.2)” 에 대한 필요성이 높게 나타났다. 둘째, 35세 이상 일차진료 의사가 34세 이하 일차진료 의사보다 전환기 돌봄서비스에 대한 인식이 높게 나타 났다(F=7.3, p<0.01). 또한, 환자중심성에 대한 인식이 높을수록, 연령이 높을수록, 서울 외 지역에서 근무할수록 전환기 돌봄서비스에 대한 인식이 높게 나타났다.결론: 본 연구에서는 일차의료를 제공하는 의료진들을 위한 교육프로그램과 지역사회에서 일차의료 의사들을 중심으로 하는 지역 연계 방안을 제시하였다는 점에서 의의가 있다.

Objectives: This study explored the direct and indirect effects of knowledge of new technology (e.g., artificial intelligence, the Internet of Things, and the Fourth Industrial Revolution), attitudes towards technology use, and smartphone utilization skills on older adults’ willingness to use home-based information and communication technology (ICT) for self-health management. Methods: A phone survey was conducted among 300 older adults aged 65 or older in Gangwon Province, Republic of Korea. A path analysis was performed to identify the direct and indirect effects of knowledge of new technology, attitudes towards technology use, and smartphone utilization skills on willingness to use home-based healthcare ICT. Socioeconomic variables were used as control variables. Results: Knowledge of new technology, but not attitudes towards technology use, had a direct impact on smartphone utilization skills. Attitude towards technology use and smartphone utilization skills showed significant effects on willingness to use home-based healthcare ICT. One standard unit change in attitudes towards technology use contributed to a 0.172 unit change in willingness (p = 0.001), and one standard unit change in smartphone utilization skills changed willingness by 0.246 units (p < 0.001). In addition, older adults with a higher education level and economic status, and lower self-related health status, were more willing to use home-based healthcare ICT. Conclusions These findings underscore the necessity of enhancing the smartphone utilization skills of older adults and attitudes towards technology use. Providing more user-friendly services and increasing smartphone utilization skills among older adults would contribute to willingness to use home-based ICT for healthcare management.

Objectives: This study explored changes in individuals’ behavior in response to social distancing (SD) levels and the “no gatherings of more than 5 people” (NGM5) rule in Korea during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Using survey data from the COVID-19 Behavior Tracker, exploratory factor analysis extracted 3 preventive factors: maintenance of personal hygiene, avoiding going out, and avoiding meeting people. Each factor was used as a dependent variable. The chi-square test was used to compare differences in distributions between categorical variables, while binary logistic regression was performed to identify factors associated with high compliance with measures to prevent transmission. Results: In men, all 3 factors were significantly associated with lower compliance. Younger age groups were associated with lower compliance with maintenance of personal hygiene and avoiding meeting people. Employment status was significantly associated with avoiding going out and avoiding meeting people. Residence in the capital area was significantly associated with higher compliance with personal hygiene and avoiding venturing out. Increasing SD levels were associated with personal hygiene, avoiding going out, and avoiding meeting people. The NGM5 policy was not significantly associated with compliance. Conclusions SD levels, gender, age, employment status, and region had explanatory power for compliance with non-pharmaceutical interventions (NPIs). Strengthening social campaigns to inspire voluntary compliance with NPIs, especially focused on men, younger people, full-time workers, and residents of the capital area is recommended. Simultaneously, efforts need to be made to segment SD measures into substrategies with detailed guidance at each level.

Objectives: This study explored the direct and indirect effects of knowledge of new technology (e.g., artificial intelligence, the Internet of Things, and the Fourth Industrial Revolution), attitudes towards technology use, and smartphone utilization skills on older adults’ willingness to use home-based information and communication technology (ICT) for self-health management. Methods: A phone survey was conducted among 300 older adults aged 65 or older in Gangwon Province, Republic of Korea. A path analysis was performed to identify the direct and indirect effects of knowledge of new technology, attitudes towards technology use, and smartphone utilization skills on willingness to use home-based healthcare ICT. Socioeconomic variables were used as control variables. Results: Knowledge of new technology, but not attitudes towards technology use, had a direct impact on smartphone utilization skills. Attitude towards technology use and smartphone utilization skills showed significant effects on willingness to use home-based healthcare ICT. One standard unit change in attitudes towards technology use contributed to a 0.172 unit change in willingness (p = 0.001), and one standard unit change in smartphone utilization skills changed willingness by 0.246 units (p < 0.001). In addition, older adults with a higher education level and economic status, and lower self-related health status, were more willing to use home-based healthcare ICT. Conclusions These findings underscore the necessity of enhancing the smartphone utilization skills of older adults and attitudes towards technology use. Providing more user-friendly services and increasing smartphone utilization skills among older adults would contribute to willingness to use home-based ICT for healthcare management.

Objectives: This study explored changes in individuals’ behavior in response to social distancing (SD) levels and the “no gatherings of more than 5 people” (NGM5) rule in Korea during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Using survey data from the COVID-19 Behavior Tracker, exploratory factor analysis extracted 3 preventive factors: maintenance of personal hygiene, avoiding going out, and avoiding meeting people. Each factor was used as a dependent variable. The chi-square test was used to compare differences in distributions between categorical variables, while binary logistic regression was performed to identify factors associated with high compliance with measures to prevent transmission. Results: In men, all 3 factors were significantly associated with lower compliance. Younger age groups were associated with lower compliance with maintenance of personal hygiene and avoiding meeting people. Employment status was significantly associated with avoiding going out and avoiding meeting people. Residence in the capital area was significantly associated with higher compliance with personal hygiene and avoiding venturing out. Increasing SD levels were associated with personal hygiene, avoiding going out, and avoiding meeting people. The NGM5 policy was not significantly associated with compliance. Conclusions SD levels, gender, age, employment status, and region had explanatory power for compliance with non-pharmaceutical interventions (NPIs). Strengthening social campaigns to inspire voluntary compliance with NPIs, especially focused on men, younger people, full-time workers, and residents of the capital area is recommended. Simultaneously, efforts need to be made to segment SD measures into substrategies with detailed guidance at each level.

Background: The effective evaluation of health information available online is an important skill. However, consumers' self-perceptions of their eHealth literacy levels do not reflect their actual capabilities. The goal of this experimental study of online search behavior is to identify differences between self-perceived eHealth literacy and actual ability to use the accuracy of cancer information available online. Methods: Thirty-one adults participated in the study conducted on July 15 and 16, 2017. We first measured perceived eHealth literacy and then asked participants 5 questions concerning cancer. Bandicam (v3.3.0) and BrowsingHistoryView were used to record search behavior and uniform resource locators, respectively. A Mann-Whitney U test and Fisher's exact test were performed. Results: The results showed that participants most frequently searched for cancer information on blogs and café websites. Regarding search behavior, those who perceived higher knowledge in available resources tended to solve the given problem with significantly smaller number of webpages to answer a weight management question. Participants who perceived higher knowledge in helpfulness of information tended to use significantly smaller number of webpages to answer questions on red ginseng's preventive effects on caner and weight management. However, there was no proof that the high eHealth literacy group had significantly higher rates of correct answers than the low eHealth literacy group. Further, regarding cancer screening, the rates of correct answers were low for groups who considered their ability higher to find helpful resources and perceived higher knowledge in helpfulness of information. Conclusion There is a gap between perceived eHealth literacy and the actual ability to use online cancer-related information. To fundamentally improve eHealth literacy, it is important to evaluate the actual abilities concerning each eHealth literacy component and to provide customized education.