A Comparative Study on Primary Health Care in Republic of Korea and Republic of Uzbekistan

Dronina, Yuliya,Moon, Jiyoung,Nam, Eun Woo Korean Academy of Health Policy and Management 2017 보건행정학회지 Vol.27 No.3

Background: Primary health care (PHC) plays a major role to ensure the basic right and equal distribution of the essential health care services. This study presents comparative analyses of PHC in Korea and Uzbekistan, discusses the existing scenario and the challenges, and provides recommendations. Methods: This study reviewed secondary data from Korea's National Statistical Information Service and the State Committee of the Republic of Uzbekistan on Statistic, regulatory legislation, research reports, and policy papers by research and international institutions. We focus on comparing input and outcome health data, PHC structure, and health expenditure. Results: Overall health status of the population in Korea is better than in Uzbekistan; both countries achieved more than 95% immunization coverage. The reforms implemented in both countries provide initial health care service delivery. However, there are several challenges such as the distribution of the staff between urban and rural areas and interest of the graduates on specialization rather than working in PHC system. Conclusion: PHC plays an important role in the provision of medical services to the population, addressing both health and social problems; it is the best tool for achieving universal coverage for basic health needs of the population. The community health practitioners in Korea and nurses in Uzbekistan plays main role in universal coverage through providing essential health care services. Continuous reform of the PHC system should be directed to strengthen the capacity of the PHC staff in health promotion knowledge and activities as well as to encourage population to improve their own health.

Comparative Study of Health Care System in Three Central Asian Countries: Kazakhstan, Kyrgyzstan, Uzbekistan

Yuliya Dronina,남은우 한국보건행정학회 2019 보건행정학회지 Vol.29 No.3

Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

Financing Mechanisms of Social Prescribing Projects: A Systematic Review

( Yuliya Dronina ),( Grace Ossak Ndombi ),( Ji Eon Kim ),( Eun Woo Nam ) 한국보건행정학회 2020 보건행정학회지 Vol.30 No.4

Aging populations and the increasing mental health issues among them have set a new challenge for the international community, governments, and people. Given this, society’s role is very important, and involving the local community in resolving the problems can play a pivotal role. The current study presented the systematic review of the financing mechanism and cost-effectiveness of the “social prescribing” (SP) project in the United Kingdom and how SP can be adapted for other settings. The data showed comparatively low running costs and the overall effectiveness of SP projects. The running cost of SP projects varied between £54,525 and £1.1 million. The cost-effectiveness of the projects reported as 12% and the return of investment was about 50% depending on the type of analysis and the activities implemented. This type of intervention can be one of the options that support solving the issues of aging populations and their accompanying mental disorders.

Older adults’ needs for post-discharge transitional care service and their predictors

Yuliya Dronina 한국노년학회 2022 한국노년학회 학술발표논문집 Vol.2022 No.1

Mediating Effects of Smartphone Utilization between Attitude and Willingness to Use Home-Based Healthcare ICT among Older Adults

조희숙,황유성,Yuliya Dronina 대한의료정보학회 2021 Healthcare Informatics Research Vol.27 No.2

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 utilizationskills 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, Republicof Korea. A path analysis was performed to identify the direct and indirect effects of knowledge of new technology, attitudestowards technology use, and smartphone utilization skills on willingness to use home-based healthcare ICT. Socioeconomicvariables were used as control variables. Results: Knowledge of new technology, but not attitudes towards technology use, had adirect impact on smartphone utilization skills. Attitude towards technology use and smartphone utilization skills showedsignificant effects on willingness to use home-based healthcare ICT. One standard unit change in attitudes towards technologyuse contributed to a 0.172 unit change in willingness (p = 0.001), and one standard unit change in smartphone utilizationskills changed willingness by 0.246 units (p < 0.001). In addition, older adults with a higher education level and economicstatus, and lower self-related health status, were more willing to use home-based healthcare ICT. Conclusions: These findingsunderscore 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 towillingness to use home-based ICT for healthcare management.

The Factors Related to Physicians’ Acceptance and Dissemination of Digital Health Services for Older Adults - Applying the Dissemination of Innovation Theory -

Heui Sug Jo(조희숙),Yuliya Dronina 한국통신학회 2020 韓國通信學會論文誌 Vol.45 No.11

Healthy City Project in Cienfuegos, Cuba

Maybin Herrera Sanchez,Yeseul Jung(정예슬),Yuliya Dronina,Eun Woo Nam(남은우) 한국보건교육건강증진학회 2020 보건교육건강증진학회지 Vol.37 No.1

Objectives: The World Health Organization’s Healthy City Project was established to increase the health commitment of citizens in urban settings and to improve deteriorating health conditions. Cuba’s Cienfuegos city introduced the “Healthy City Project”, adapting the concept with projects based in primary healthcare. The study aimed to review the implementation of this project in Cienfuegos City, Cuba. Methods: Cuba’s Healthy City Project was reviewed by analyzing the experiences of Cienfuegos city. Relevant literature related to the implementation of the Healthy City Project was also reviewed and web-based gray literature was assessed, searched, and selected. Additionally, reports from Google Scholar and the Scientific Electronic Library Online were used to gather complementary information. Results: Initiated in 1989, the city of Cienfuegos used the Healthy City Project as a strategy for health promotion, lifestyle modification, and disease prevention. It undertook this initiative as the local government’s plan to help reduce non-communicable diseases and the associated initiatives to transform the city into a healthier one has proven to be successful, especially by involving the community and engendering the government’s political commitment. The Project has involved schools and hospitals to improve personal and community health. Conclusion: The Project has been proven effective by involving the community, yet there are some considerations, such as upgrading the evaluation system, that would improve the overall outcome of the Project.

Relationship between obesity and eating rate: Analyzing the Korean Community Health Survey data

Heui Sug Jo,Su Mi Jung,Yuliya Dronina 한국보건교육건강증진학회 2020 보건교육건강증진학회지 Vol.37 No.3

Objectives: There is an increase in the rate of obesity in South Korea as a result of changing dietary habits and decreasing physical activity. This study aimed to evaluate the relationship between eating rate and obesity. Methods: Multiple logistic regression analyses were conducted using raw data from the Korean Community Health Survey 2017 for Gangwon Province data to evaluate the relationship between eating rate and obesity. Results: Among men, the major factor affecting obesity was an eating rate of ≤0 min (odds ratio=1.16 (1.02, 1.33); p<.05). In women, factors affecting obesity were an eating rate of ≤0 min (odds ratio=1.14 (1.02, 1.28); p<.05), and irregular mealtimes (odds ratio=1.15 (1.02, 1.29); p<.05). Eating out was found to be a significantly important factor among both genders when participants eat-out once a day or less. Conclusion: Implementing simple strategies to improve dietary and lifestyle habits may assist in weight and obesity management. These findings provide useful information for developing future strategies in obesity prevention.

Comparison of the Health Insurance Systems of South Korea and Peru

김양희,Martín Tantaleán-Del-Aguila,Yuliya Dronina,남은우 한국보건행정학회 2020 보건행정학회지 Vol.30 No.2

Background: The public health care system of a country is shaped and driven by its historical background as well as social, economic, and cultural structures. This study sheds light on the unique features, strengths, and weaknesses of the health insurance systems of South Korea (Korea) and Peru. Methods: The capacity mapping tool was used to explore the Korean and Peruvian population and geographical structures; health insurance laws, regulations, and policies; payment systems; eligibility and contribution collection; and long–term care insurance. Results: The study found that the Korean government took the lead in integrating multiple insurers into a single–payer system in an effort to reinforce and stabilize its health insurance system in 2000. Peru has been developed mixed model such based on taxes and contributions, to address a gap between different social classes. Peruvian government developed a two–axis system, one for low–income earners, financed by taxes, and another financed by contributions paid by workers and government officials in the formal sector. Peru has introduced many variations to its fee payment and insurer systems, target population, and coverage scope, and maintains its health insurance system accordingly to this day. Conclusion: The current study provides observation of the Health Insurance System in two different countries and helps to understand possible ways to improve the health insurance system in both countries. Based on this study, Peru will be able to see how its system differs from Korea’s and benefit from the related policy implications.

농촌 중년여성 비만원인 진단을 위한 사회생태학적 모형 기반 탐색적 연구

조희숙(Heui Sug Jo),이종선(Jong Sun Lee),정수미(Su Mi Jung),드로니나 율리아(Yuliya Dronina),박유경(Yu Kyung Park),박양준(Yang Jun Park) 한국보건교육건강증진학회 2021 보건교육건강증진학회지 Vol.38 No.5

Objectives: This study aimed to explore the causes of obesity among middle-ageed women in rural areas through a socio-ecological approach and propose strategies of obesity management. Methods: We selected two rural areas called the I and Y counties. For the quantitative aspect, secondary data and geospatial-analysis were used, whereas for the qualitative aspect, focus group interviews and official documents reviews were conducted. Results: Obesity was related more to low levels of physical activity (OR=1.811, p<.01) than to high levels. Groups that utilized nutritioin labels less tended to be more obese (OR=1.564, p<.05) than the other groups. The number of fast-food stores in the I county was twice as high as that in the Y county. The I county had poor conditions than the Y county in terms of public resources. The related factors could be divided in the following categories: (1) Body weight self-management; (2) Peers to exercise together; (3) Access to fresh food and exercise facility; (4) Health budget and lack of leisure programs. Conclusion: There were various obesity causes, and, thus, intervening one factor cannot be a proper solution. Therefore, a social-ecological approach should be utilized to address the obesity issues.