- Measuring Myun Health Worker's Performance by Time-Activity Approach.
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Han Joong Kim, Moon Shik Kim
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Korean J Prev Med. 1977;10(1):34-43.
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 Abstract
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- This study attempts to examine the performances of Myun Health Workers-the frontline workers in the Korean rural health care delivery system. The time-activity approach was mainly utilized as a measuring tool. This study was undertaken in September 1976 with 35 Myun Health Workers at the Kang Wha Country. The pretested time-activity approach sheets were filled out daily for one month by those Myun Health Workers themselves. Statistical means and variances of analysis were utilized for statistical method in comparing some activities and functions converged into time distribution. Findings: 1. The workers's average working hours derived in this study is 8 hours and 48 minutes per day, which takes half an hour longer than normal schedule. 2. They spend 56% working hour for direct services, in other words, the main function, 22% for supportive function, and 22% for other activities, the unrelated health services. 3. Considering the total working hours of main function, out-center activity is far more than in-center services with the ratio of 70% to 30% respectively, which proves, therefore, that the main activity of the workers is home visiting. 4. It takes 20 minutes purely for home visition and takes 14 minutes for transportation. 5. This research also indicates that such factors as characteristics of the health workers and myun influence in shaping the structures of the worker's function and activity: a. The workers whose working site is located is myun office spend 15% among total working hours in carring out official myun activities, which is incidentally unrelated to health services, while the health subcenter have no rooms for administrative jobs for myun office. b. The workers whose office is in health subcenter contribute much time in doing main function and those working in special project distribute more time in performing supportive function. c. The types of workers are another dominant factor to influence the components of worker's functions and activities. d. MPW II, whose function is reorganized by special project in 2 myuns shows different pattern of time distribution compared to the TB worker orFP worker in the ordinatry area. MPW II distributes their time evenly in performing MCH program, T.B. program, F.P. program and education activity, while the unipurpose workers engage in carring out only their dominant role. e. Another variables which involve th variation of the worker's activity can be illustrated with the variables like target population, size of myun and convenience for transportation, among which the latter two are remarkable factors in determining the time for out-center service.
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Summary
- Study of Medical Carein Health Subcenter.
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Moon Shik Kim, Han Joong Kim, Young Key Kim, Il Soon Kim
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Korean J Prev Med. 1976;9(1):109-116.
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- Reorganization of myun health care service is one of the main issues in health care delivery in rural Korea. The fundamental, concept of the role and function of the myun health subcenter is that it is the basic unit of rural health care service and is to provide comprehensive health care service through the integration of curative and preventive services. The aim of this study is to analyze the patterns of curative activities in the myun health subcenter in terms of the most prevalent types of diseases, necessary diagnostic methods and required equipment, types of treatment, necessary drugs and materials, and finally the cost of curative services. The population on which this study was done was the 1596 patients who visited the two myun health subcenters (Sunwon Myun and Naega Myun) in Kang Hwa County, the area of the Yonsei University Community Health Teaching Project, during period from May 1, 1975 to June 10, 1976. For the patient's record in the clinic, problem oriented medical records were used. Decisions regarding the disease classification, the diagnostic methods used and selection of the most appropriate and adequate medical treatment were made by a group of three experienced physicians after reviewing the medical records which had been written by public physicians who were treating patients in the study area. The records were reviewed by resident staff members of the Department of Preventive Medicine, of Yonsei University College of Medicine. A brief summary of results of the study is as follow: 1. 29.9% of the patients who visited the clinics were ages between 0-4. No sex difference was observed among patients less than 20 years of age. However, among patients over 20 years old, females predominated. Thus it is evident that the majority of patients were either children or mothers and grandmothers. 2. The distance from the individual villages to the myun health subcenter was one of important factors in determining the ratio of clinic visits. However, other factors such as the activities of the health workers also affected the rates substantially. 3. The most common 25 diseases comprised 90.2% of all the diseases recorded. Acute respiratory infection (25.5), skin (12.7%), diarrheal diseases (6.8%), neuralgia and back pain (4.9%) and all other injuries (3.9%) were the five most common diseases. 4. Of all the diseases diagnosed and treated, 9.2% required simple laboratory tests for diagnosis, 6.5% required X-ray examination, and altogether 13.6% required either laboratory test of X-ray examination. 5. Treatment and management of 42.0% of the cases could be accomplished with simple, inexpensive drugs, 12.8% required the use of more expensive drugs (mostly antibiotics) and injections were required in 19.7% of the cases. Minor surgery and referral were necessary in 5% of the cases. 6. The cost for diagnosis and treatment was estimated with a standard which was set by general concensus. The average cost of diagnosis was 144 per case and the cost of treatment was 726 per case. The total average cost per visit was 870.
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Summary
- A study on improvement of school lunch program in a demonstration school (II).
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Myung Ho Kim, Won Duck Lee, Young Ok Kim, Moon Shik Kim
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Korean J Prev Med. 1976;9(1):95-108.
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- It is obvious that adequate nutrition is essential for growth and development of school children, and many elementary schools in this country have already practiced it. Therefore, it would seem apparent that the school feeding program would have a significant effect on the growth and development of school children. This paper presents a two-year experimental school-feeding program from 1973 to 1974, and attempts to evaluate its effects by before-and-after nutrition surveys conducted in two elementary schools, one experimental and the other as a control. The two schools are both located in the same county (Yongin-Kun, Kyunggi-Do), and the families of their students are presumed to share the same socio-economic level. To assess the effect of school-feeding, we measured height, weight, chest circumference and grasping power. Physical examination was done foresigns of nutritional deficiency. A stool examination for parasites and blood examinations for hemoglobin, hematocrit and serum protein were included. Analysis were done for 150 students selected randomly at the beginning of the program. These students attended the school throughout the program period. Results are as follows: 1. The amount of increase of height, weight, chest circumference and grasping power were greater in the experimental school than in the control school, but the differences are not statistically significant. 2. Signs of vitamin deficiency decreased in both experimental and control schools during the two-year program period. 3. At the time of the 1974 post-survey, values of Hb. & Hct. revealed no significant differences between the two schools, but serum protein level was a little higher than that of general Korean rural children of the same age. 4. Infestation rate of parasites had increased in both schools during the two-year program period. 5. Each student of the two schools was classified into three major classes, according to the level of economic condition of his or her parents, namely higher, middle and lower. The results of each class of the experimental school was compared with that of the corresponding class of the control school, expecting the relative magnitude of change largest in the lower economic class of the experimental school. However, change was greatest in the middle class, still not being statistically significant. Finally, the authors concluded that the two-year period for such a program is not sufficiently long for its beneficial effects to be demonstrated and measured. As long as the growth and development of children are concerned, planning with a more distant perspective is required, as well as the development of new methods of evaluation.
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