Journal of Preventive Medicine and Public Health

Brief Report

How Well Do U.S. Primary Care and Obstetrics and Gynecology Clinicians Screen for Pregnancy Complications at Well Woman Visits? A Retrospective Cohort Study: Eli D. Medvescek, Sorana Raiciulescu, Andrew S. Thagard, Katerina Shvartsman; J Prev Med Public Health. 2023;56(2):190-195. Published online March 15, 2023; DOI: https://doi.org/10.3961/jpmph.22.492

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Abstract PDF: Objectives
Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology.
Methods
We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate.
Results
In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively).
Conclusions
Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions.; Summary

Original Article

SWOT Analysis and Expert Assessment of the Effectiveness of the Introduction of Healthcare Information Systems in Polyclinics in Aktobe, Kazakhstan: Lyudmila Yermukhanova, Zhanar Buribayeva, Indira Abdikadirova, Anar Tursynbekova, Meruyert Kurganbekova; J Prev Med Public Health. 2022;55(6):539-548. Published online October 11, 2022; DOI: https://doi.org/10.3961/jpmph.22.360

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Abstract PDF: Objectives
The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan.
Methods
The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires.
Results
The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners.
Conclusions
The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees’ working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.; Summary

Perspective

Group Antenatal Care: A Paradigm Shift to Explore for Positive Impacts in Resource-poor Settings: Bhanu Pratap Singh Gaur, Jyothi Vasudevan, Bhabani Pegu; J Prev Med Public Health. 2021;54(1):81-84. Published online December 8, 2020; DOI: https://doi.org/10.3961/jpmph.20.349

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Abstract PDF

The delivery of high-quality antenatal care is a perennial global concern for improving maternal and neonatal outcomes. Antenatal care is currently provided mainly on a one-to-one basis, but growing evidence has emerged to support the effectiveness of group antenatal care. Providing care in a small group gives expectant mothers the opportunity to have discussions with their peers about certain issues and concerns that are unique to them and to form a support system that will improve the quality and utilization of antenatal care services. The aim of this article is to promote group antenatal care as a means to increase utilization of healthcare.

Summary

Citations

Citations to this article as recorded by

Improving health literacy through group antenatal care: results from a cluster randomized controlled trial in Ghana
Jody R. Lori, Vida Ami Kukula, Liya Liu, Veronica E.A. Apetorgbor, Bidisha Ghosh, Elizabeth Awini, Nancy Lockhart, Georgina Amankwah, Ruth Zielinski, Cheryl A. Moyer, John Williams
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef
Magnitude, disparity, and predictors of poor-quality antenatal care service: A systematic review and meta-analysis
Dereje Bayissa Demissie, Gebeyaw Molla, Firew Tiruneh Tiyare, Abebe Sorsa Badacho, Ashenif Tadele
SAGE Open Medicine.2024;[Epub] CrossRef
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Effect of group antenatal care versus individualized antenatal care on birth preparedness and complication readiness: a cluster randomized controlled study among pregnant women in Eastern Region of Ghana
Vida A. Kukula, Elizabeth Awini, Bidisha Ghosh, Veronica Apetorgbor, Ruth Zielinski, Georgina Amankwah, Winfred K. Ofosu, Katherine James, John E. O. Williams, Jody R. Lori, Cheryl A. Moyer
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef
Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali
Aissata Ba, Monica J. Fox, Adama Mamby Keita, Kristen M. Hurley, Shannon E. King, Samba Sow, Kounandji Diarra, Mahamane Djiteye, Baba Seydou Kanté, Moussa Coulibaly, Ousmane Dembele, Lisa M. Noguchi, Pooja Sripad, Peter J. Winch
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Adolescents’ experiences with group antenatal care: Insights from a mixed‐methods study in Senegal
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Tropical Medicine & International Health.2021; 26(12): 1700. CrossRef

COVID-19: Original Article

An Observational Study in Manipur State, India on Preventive Behavior Influenced by Social Media During the COVID-19 Pandemic Mediated by Cyberchondria and Information Overload: Renu Bala, Amit Srivastava, Gouri Devi Ningthoujam, Thadoi Potsangbam, Amita Oinam, Ch Lily Anal; J Prev Med Public Health. 2021;54(1):22-30. Published online December 1, 2020; DOI: https://doi.org/10.3961/jpmph.20.465

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Abstract PDF Supplementary Material

Objectives
The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency posing unprecedented challenges for health authorities. Social media may serve as an effective platform to disseminate health-related information. This study aimed to assess the extent of social media use, its impact on preventive behavior, and negative health effects such as cyberchondria and information overload.
Methods
A cross-sectional observational study was conducted between June 10, 2020 and August 9, 2020 among people visiting the outpatient department of the authors’ institution, and participants were also recruited during field visits for an awareness drive. Questions were developed on preventive behavior, and the Short Cyberchondria Scale and instruments dealing with information overload and perceived vulnerability were used.
Results
The study recruited 767 participants with a mean age of about 45 years. Most of the participants (>90%) engaged in preventive behaviors, which were influenced by the extent of information received through social media platforms (β=3.297; p<0.001) and awareness of infection when a family member tested positive (β=29.082; p<0.001) or a neighbor tested positive (β=27.964; p<0.001). The majority (63.0%) of individuals often searched for COVID-19 related news on social media platforms. The mean±standard deviation scores for cyberchondria and information overload were 9.09±4.05 and 8.69±2.56, respectively. Significant and moderately strong correlations were found between cyberchondria, information overload, and perceived vulnerability to COVID-19.
Conclusions
This study provides evidence that the use of social media as an information- seeking platform altered preventive behavior. However, excessive and misleading information resulted in cyberchondria and information overload.

Summary

Citations

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Predictors of Cyberchondria During the COVID-19 Pandemic: Cross-sectional Study Using Supervised Machine Learning
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Federica Ambrosini, Roberto Truzoli, Matteo Vismara, Daniele Vitella, Roberta Biolcati
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Original Articles

Association Between Convenience of Transportation and Unmet Healthcare Needs of Rural Elderly in Korea: Youngeun Choi, Kiryong Nam, Chang-yup Kim; J Prev Med Public Health. 2019;52(6):355-365. Published online October 3, 2019; DOI: https://doi.org/10.3961/jpmph.19.172

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Abstract Summary PDF Supplementary Material

Objectives
In rural areas of Korea, where public transportation infrastructure is lacking and alternative systems are poor, the elderly experience inconveniences in using healthcare, although their need is high. This study aimed to analyze the association between the convenience of transportation and unmet healthcare needs among the rural elderly.
Methods
The data used were collected in the 2016 Community Health Survey among rural elderly individuals aged 65 or older. Dependent variable was the unmet healthcare needs, explanatory variable was the convenience of transportation. The elderly were divided into 3 groups: with no driver in the household, with a driver, and the elderly individual was the driver (the self-driving group). Covariates were classified into predisposing, enabling, and need factors. They included gender, age, education, income, economic activity, household type, motor ability, subjective health level, number of chronic diseases, anxiety/depression, and pain/discomfort. The data were analyzed using logistic regression and stratification.
Results
A significant association was found between the convenience of transportation and unmet healthcare needs. When examined unadjusted odds ratio of the group with a driver in the household, using the group with no driver as a reference, was 0.61 (95% confidence interval [CI], 0.54 to 0.68), while that of the self-driving group was 0.34 (95% CI, 0.30 to 0.38). The odds ratios adjusted for all factors were 0.69 (95% CI, 0.59 to 0.80) and 0.79 (95% CI, 0.67 to 0.91).
Conclusions
We confirmed a significant association between inconvenient transportation and unmet healthcare needs among the rural elderly even after adjustment for existing known factors. This implies that policies aimed at improving healthcare accessibility must consider the means of transportation available.

Summary

Korean summary
대중교통 인프라가 부족하고 대안적 교통수단 체계가 미흡한 농촌 지역 노인들은 의료 필요는 높으나 도보이동이나 불편한 이동수단을 이용하기 어려워 의료이용에 불편을 겪는다. 본 연구는 의료접근성 향상과 불평등한 접근성 문제에 대한 제안의 근거 마련을 목적으로 질병관리본부 지역사회건강조사 데이터를 이용하여 농촌 노인의 이동수단의 편의성과 미충족의료 경험의 연관성을 살펴보았다. 분석결과 농촌지역 노인에게 교통편 불편은 미충족의료 경험의 주된 이유로 나타났고 기존에 알려진 요인들을 보정한 후에도 이동수단의 편의성과 미충족의료 경험 사이에 유의한 관계가 있음을 확인하였다.

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Barriers to Health Service Utilization Among Iranian Female Sex Workers: A Qualitative Study: Mehran Asadi-Aliabadi, Jamileh Abolghasemi, Shahnaz Rimaz, Reza Majdzadeh, Fereshteh Rostami-Maskopaee, Effat Merghati-Khoei; J Prev Med Public Health. 2018;51(2):64-70. Published online February 6, 2018; DOI: https://doi.org/10.3961/jpmph.17.174

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322 Download
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Abstract PDF

Objectives
In most countries around the world, sex work is an illegal activity. Female sex workers (FSWs) in Iran hide their identities, and they are known to be a hard-to-reach population. Despite free access to HIV testing, fewer than half of FSWs receive HIV testing. The purpose of this study was to characterize the reasons for which FSWs do not seek testing at drop-in centers (DICs) and voluntary counseling and testing (VCT) centers in Iran. Methods: A qualitative study was conducted in 2016. The participants were 24 FSWs who received services at VCT centers and DICs for vulnerable females in the north of Iran and 9 males who were the clients of FSWs. In this study, we made use of purposive sampling and carried out a thematic analysis. Results: We found 4 major and 6 minor themes. The major themes were: fear of being infected (with HIV), stigma, indifference, and knowledge. Conclusions: Despite the significant efforts made by the government of Iran to establish and expand DICs for vulnerable females, the number of FSWs receiving services at these centers has not been very considerable. Consequently, by introducing and implementing training programs for peer groups, it may be possible to take steps toward establishing strategic programs for the control and prevention of HIV/AIDS.

Summary

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Mehran Rostami, Aboubakr Neshati-Khorram, Shahab Rezaeian
International Journal of High Risk Behaviors and Addiction.2019;[Epub] CrossRef

A Survival Analysis of Gastric or Colorectal Cancer Patients Treated With Surgery: Comparison of Capital and a Non-capital City: Nam-Soo Hong, Kyeong Soo Lee, Sin Kam, Gyu Seog Choi, Oh Kyoung Kwon, Dong Hee Ryu, Sang Won Kim; J Prev Med Public Health. 2017;50(5):283-293. Published online July 3, 2017; DOI: https://doi.org/10.3961/jpmph.17.043

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Abstract PDF Supplementary Material

Objectives
The objective of the present study was to compare prognosis of patients with gastric or colorectal cancer according to places where they received surgeries. Methods: The cancer patients underwent surgeries in sampled hospitals located in Daegu were matched 1:1 to the patients who visited sampled hospitals in Seoul using propensity score method. After the occurrences of death were examined, Kaplan-Meier method was used for survival analysis and the log-rank test was performed to compare the survival curves. Results: A total of six out of 291 gastric cancer patients who had surgeries in Daegu died (2.1%) and ten deaths (3.4%) occurred from patients went Seoul hospitals. Out of 84 gastric cancer patients who had chemotherapy after surgeries in Daegu, 13 (15.5%) patients died while 18 (21.4%) deaths occurred among patients underwent surgeries in Seoul. Six deaths (6.9%) out of 87 colorectal cancer patients who had surgeries in Daegu were reported. Five patients (5.7%) died among the patients underwent surgeries in Seoul. Among the colorectal cancer patients with chemotherapy after surgeries, 13 patients (12.4%) who visited hospitals in Daegu and 14 (13.3%) patients who used medical centers in Seoul died. There were no significant differences according to places where patients used medical services. Conclusions: The result of this study is expected to be used as basic data for policy making to resolve centralization problem of cancer patients and to help patients to make rational choices in selection of medical centers.

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Domestic medical travel from non-Seoul regions to Seoul for initial breast cancer treatment: a nationwide cohort study
Jae Ho Jeong, Jinhong Jung, Hee Jeong Kim, Jong Won Lee, Beom-Seok Ko, Byung Ho Son, Kyung Hae Jung, Il Yong Chung
Annals of Surgical Treatment and Research.2023; 104(2): 71. CrossRef
MCR1 and KPC2 Co-producing Klebsiella pneumoniae Bacteremia: First Case in Korea
Ji Young Park, Sang Taek Heo, Ki Tae Kwon, Do Young Song, Kwang Jun Lee, Ji Ae Choi
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The Effect of Residential Area and Hospital Bed Size on the Use of Hospital in Other Regions for Cancer Inpatients
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The Association Among Individual and Contextual Factors and Unmet Healthcare Needs in South Korea: A Multilevel Study Using National Data: Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon; J Prev Med Public Health. 2016;49(5):308-322. Published online September 7, 2016; DOI: https://doi.org/10.3961/jpmph.16.035

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Abstract PDF

Objectives
The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors.
Methods
The present study used data from the 2012 Korean Community Health Survey (KCHS) of 228 902 adults residing within 253 municipal districts in South Korea. A multilevel analysis was conducted to investigate how contextual characteristics, defined by variables that describe the regional deprivation, degree of urbanity, and healthcare supply, are associated with unmet needs after controlling for individual-level variables.
Results
Of the surveyed Korean adults, 12.1% reported experiencing unmet healthcare needs in the past. This figure varied with the 253 districts surveyed, ranging from 2.6% to 26.2%. A multilevel analysis found that the association between contextual characteristics and unmet needs varied according to the factors that caused the unmet needs. The degree of urbanity was associated with unmet need due to “financial burden” (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.42 to 0.66 for rural vs. metropolitan), but not unmet need due to “service not available when needed.” There were no significant associations between these unmet need measures and regional deprivation. Among individual-level variables, income level showed the highest association with unmet need due to “financial burden” (OR, 5.63; 95% CI, 4.76 to 6.66), while employment status showed a strong association with unmet need due to “service not available when needed.”
Conclusions
Our finding suggests that different policy interventions should be considered for each at-risk population group to address the root cause of unmet healthcare needs.

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Purity Njagi, Jelena Arsenijevic, Wim Groot
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Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys: Dong Hee Ryu, Sin Kam, Young-Taek Doo; J Prev Med Public Health. 2016;49(2):118-128. Published online March 24, 2016; DOI: https://doi.org/10.3961/jpmph.16.003

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Abstract PDF

Objectives
The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services.
Methods
The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012.
Results
At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only (‘I’-only) and of fixed amount+indemnity-type (‘F+I’) increased, whereas the proportion of holders with fixed amount-type only (‘F’-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding out-patient care, subjects with ‘F’-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with ‘I’-only PMI or ‘F+I’ PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for ‘I’-only: 1.39, 1.63, and 1.38, respectively; ORs for ‘F+I’: 1.67, 2.09, and 1.37, respectively).
Conclusions
The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.

Summary

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Dong-Hee Ryu, Yong-jun Choi, Jeehye Lee
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Nahabwe Haven, Andrew E. Dobson, Kuule Yusuf, Scott Kellermann, Birungi Mutahunga, Alex G. Stewart, Ewan Wilkinson
Frontiers in Public Health.2018;[Epub] CrossRef

English Abstracts

Crisis Intervention for Workers in Severely Stressful Situations After Massive Layoffs and Labor Disputes.: Jong Min Woo, Jeong Ho Chae, Soo Chan Choi; J Prev Med Public Health. 2010;43(3):265-273.; DOI: https://doi.org/10.3961/jpmph.2010.43.3.265

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Abstract PDF

OBJECTIVES
Due to the economic crisis and globalization, many workers have been suffering from severe occupational stress due to job insecurity and struggles related to downsizing and restructuring. This study aims to assess the stress levels among workers involved in fierce labor disputes and massive layoffs and to evaluate their specific needs and satisfaction with counseling services set up to help workers cope with severely stressful situations? METHODS: The authors provided crisis intervention to workers in traumatic situations to compare the differential level of stress responses and needs among the workers remaining employed in a large auto factory, those laid off by it, and those laid off by other companies in the same region (Pyeongtaek, Gyeonggi Province). We measured stress levels using the worker's stress response inventory (WSRI) and heart rate variability (HRV), and assessed workers' satisfaction with the counseling services. RESULTS: 502 workers participated in the program. Fifty-seven percent of them consulted with occupational problems. The mean WSRI score of the workers remaining employed in the automobile factory was higher than that of the unemployed (employed: 39.8+/-19.9, unemployed: 29.3+/-18.8). Ninety-five percent of workers responded that they were satisfied or very satisfied with the counseling services. CONCLUSIONS: This study suggests the urgent need for the establishment of a national crisis intervention program dedicated to supporting workers in severely stressful situations.

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Can We Blame the Climate of an Organization for the Stress Experienced by Employees?
Sanjeev P. Sahni, Vaijayanthee Kumar
Jindal Journal of Business Research.2012; 1(2): 181. CrossRef

Socioeconomic Inequalities in Preventive Services among the Elderly: Results from Medical Checkup, Cancer Check, and BP Check.: Heeran Chun, Il Ho Kim; J Prev Med Public Health. 2007;40(5):404-410.; DOI: https://doi.org/10.3961/jpmph.2007.40.5.404

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Abstract PDF

OBJECTIVES
Due to the assumptions of homogeneity as well as challenges in the socioeconomic position of the elderly, they have been relatively neglected in studies of health inequalities. Therefore, this study was conducted to investigate the social inequalities in preventive services among elderly men and women. METHODS: Data were obtained from a nationally representative sample of 342 men and 525 women aged 65 and over collected during the 2001 National Health and Nutrition Examination Survey. Age adjusted proportions and logistic regression were used to identify the social patterning of preventive services among elderly Koreans using various social position indicators. RESULTS: The findings of this study generally supported the presence of social gradients in preventive services among the Korean elderly. The likelihood of using the service becomes progressively higher with social position. Educational level, income, and self-rated living status were significantly associated with increased medical checkups and cancer checks. In addition, logistic regression detected educational inequalities only among older women receiving BP checks. After being stratified based on health status and chronic disease status, social disparities still existed when educational level and self-rated living status were considered. Among unhealthy individuals, place of residence was observed as a barrier to medical checkups. CONCLUSIONS: This study demonstrated strong and consistent associations between socioeconomic position and preventive services among the elderly in Korea. The results indicate that public health strategies should be developed to reduce the barriers to preventive services encountered by the elderly.

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Esther Priscilla Biamah Danquah, Samuel Agyei Agyemang, Samuel Amon, Moses Aikins
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Factors Affecting Cancer Screening Behavior in the Elderly : Based on Andersen's Model and Health Belief Model
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Huisu Eom, Jun-Pyo Myong, Eun-A Kim, Bohwa Choi, Soon Woo Park, Young Joong Kang
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Kyung-Hyun Choi, Jeongyun Heo, Soyeun Kim, Young-Jee Jeon, Myungju Oh
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Original Article

Development and Evaluation of the Reliability and Validity of the VSSS-82 Korean Version for Measuring Satisfaction with Community-based Mental Health Services in Psychiatric Patients.: Weon Seob Yoo, Young Jeon Shin, Ok Ryun Moon, Jung Hyun Nam; Korean J Prev Med. 2001;34(3):211-218.

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Abstract PDF: OBJECTIVES
To develop a Korean version of VSSS-82 for measuring the multi-dimensional satisfaction with community-based mental health services in psychiatric patients and to investigate both the reliability and validity of the Korean version. METHODS: The VSSS-82 English version was translated and back-translated with some modification. Data from 68 psychosis patients using community-based mental health services in three Community Mental Health Centers (CMHCs) was collected through a personal interview survey regarding the satisfaction and suitability of service. Variability of satisfaction and internal consistency, discriminant validity, and concurrent validity of the VSSS-82 Korean version were evaluated. RESULTS: A higher number of dissatisfied subjects and significant pairwise differences for the dimensions were found. The Crohnbach's alpha coefficient, a measure of internal consistency, ranged from 0.56 (overall satisfaction) to 0.90 (skills and behavior) and significant differences in satisfaction was found in patients by the self-rated suitability of service. CONCLUSIONS: The VSSS-82 Korean version is a reliable and valid instrument for measuring multi-dimensional satisfaction with community-based mental health service.; Summary

Comparative Study

Differences in Medical Care Utilization Rates of the Disabled and the Non-disabled with Ambulatory Care Sensitive Conditions.: Sang Jun Eun, Jee Young Hong, Jin Yong Lee, Jin Seok Lee, Yoon Kim, Yong Ik Kim, Youngsoo Shin; J Prev Med Public Health. 2006;39(5):411-418.

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Abstract PDF: OBJECTIVES
The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. METHODS: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. RESULTS: The numbers of physician visits per 100 patients were 0.78~0.97 times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were 1.16~1.77 times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: 0.44~0.70), and the ORs of hospitalization for the disabled were significantly higher (OR: 1.16~1.89). The lower physician visit group (number of physician visits < or =1) was more likely to be hospitalized than the higher physician visit group (number of physician visits > or =2) (OR: 1.69~19.77). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. CONCLUSIONS: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.; Summary

English Abstract

The Continuum of Rehabilitation Care and the Rehabilitation Services that are Needed by People with Severe Disabilities.: Soong Nang Jang, Seonja Rhee, Wan Ho Kim, Kyu Beom Lee, Sukyung Kim, Jae Young Lim; J Prev Med Public Health. 2006;39(3):263-269.

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Abstract PDF: OBJECTIVES
As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. METHODS: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care. RESULTS: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. CONCLUSIONS: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.; Summary

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