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KMID : 0667720000370000364
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Report Natlonal Institute of Health
2000 Volume.37 No. 0 p.364 ~ p.366
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Study on the development of preventive program of chronic degenerative disease in Community Health Center level
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김태숙/Kim, T. S.
함철호/송순태/문창진/신혜령/김수영/정은경/Ham, C. H./Song, S. T./Moon, C. J./Shin, H. R./Kim, S. Y./Jeong, E. K.
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Abstract
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Purpose : Home-based elderly people with chronic degenerative diseases have two desires, one is the desire of public health (disease), the other is that of welfare (problem of poverty). That is to say, the elderly patients have two desires at the same time. While the Community Health Center has dealt with the disease problem, the welfare organization has handled the poverty problem. According to the WHO report (Linking Health Care and Social Services), these kinds of separated services are said to be broken services, inappropriate services and discontinuous services. The desirable services are the integration of medical and Welfare services. In Korea, there is no plan for the integration of medical and welfare services. Model project for public health and welfare was proposed, but there was no positive evaluation toward the project.
In order to prepare for the increase of chronic degenerative elderly people, it is necessary to make the concrete plan for the public health and welfare.
Prior to the concrete plan, we must overview the following items :
- Connection between Community Health Center and other welfare organization
- Attitude of public health and welfare workers toward care management as the preventive program of chronic degenerative diseases in home-based elderly people.
Methods : ○ We have reviewed the studies of chronic degenerative diseases. These studies have focused on one aspect, namely, they had no relationship and no inter-professional care between public health experts and welfare professionals.
○ We have reviewed the followings:
- the relationship between inter-Agency
- the inter-professional care the concept of cooperation of public health activities
- the contents, mode, inhibitory factor and stimulating factor of the program
- the enquetes
The enquetes consist of four items:
- cooperation status of inter-Agency
- necessity and positive aspect of cooperation
- the inhibitory and stimulating factors of cooperation
- model development program
○ This study was based on the inter-Agency cooperation services toward the chronic degenerative elderly people in Suso, Gangnam-gu. We compared Suso area public health activity with that of Wolgye area.
○ The surveys were composed of two aspects.
First, the enquetes for home-based social welfare officials and workers including home nurses.
Second, the recipients who got the chronic degenerative disease services.
Result : ○ In providing the chronic degenerative disease services, the connection between inter-Agency was seldom done until now. The confidence and correspondence between inter-Agency were a very low level. So the inter-Agency connection was made only by individual acquaintance, not by official routes. That is, the roles of public health professionals and welfare workers must be separated.
○ The majority of the respondents replied that their recipients could get the better services in case of connection between Community Health Center and community welfare organization. The positive aspects were improvement of the services and prevention of duplicate services. As shown in the cases of recipients and organizations, various social resources are connected with the clients. These facts proved to be necessary to connect Community Health Center with welfare organization.
○ As cooperative cases between public health and welfare, the recipients of Suso area services got more than those of Wolgye area, but their was no difference in routine daily activities and degree of satisfaction.
○ The main problem in inter-professional care is overload, limitation of time and shortage of resources.
○ The inhibitory factors of connection are limitation of time due to overload and unclear roles between inter-professional care. In order to resolve these problems, the respondents replied that it is necessary to enact the laws and to educate the personnel.
○ The public health and welfare professionals who work in community health organization replied to the importance of connection. The supervisors have concerns in connection between inter-Agency and it accounts for 50%.
○ Community health professionals think that functional integration is better than that of organization. This showed the services providers´ opinion.
○ It is desirable that the integration services of public health and welfare must flow from lower levels to higher ones.
○ The reply toward "Health and Social Care Management" was positive, but the majority of the respondents (80%) didn´t know it.
○ Finally, social welfare workers turned out to be the most passive groups, while the home-based welfare workers were the most positive group.
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