Table 1
Community health and social care resources for PWDs and their main services.
| COMMUNITY HEALTH AND SOCIAL CARE RESOURCES | MAIN SERVICES | |
|---|---|---|
| Medical | Primary health care teams for PWDs |
|
| Rehabilitation medical centers (clinic, hospital) |
| |
| Medical centers (primary, secondary, tertiary hospital) |
| |
| Disability-friendly health checkup facilities |
| |
| Dental care centers for the persons with special needs |
| |
| Public health | Regional health & medical centers for PWDs |
|
| Community mental health welfare centers |
| |
| Public health centers: community-based rehabilitation teams |
| |
| Public health centers: visiting nursing teams |
| |
| Social welfare | Social welfare centers for PWDs |
|
| Residential homes for PWDs |
| |
| Day care centers for PWDs |
| |
| Vocational rehabilitation facilities for PWDs |
| |
| Social service centers (activity assistant or long-term care) |
| |
| Assistive technology service centers |
| |
| Mobility support centers for the transportation vulnerable |
| |
| Community service centers (local government office) |
| |
| Advocacy agencies for PWDs |
| |
| Family support centers for PWDs |
| |
| Disability association | Associations of PWDs |
|
[i] Abbreviations. PWDs = People with disabilities.
Table 2
Characteristics of the study populations.
| VARIABLES | N (%) |
|---|---|
| Total | 203 (100.0) |
| Work experience in disability-related organizations | |
| Less than 1 year | 34 (16.75) |
| 1–3 years | 45 (22.17) |
| 3–5 years | 31 (15.27) |
| 5–10 years | 35 (17.24) |
| More than 10 years | 58 (28.57) |
| Affiliated organizations | |
| Type 1. Medical service (clinics, hospitals, rehabilitation medical centers, dental hospitals) | 58 (28.57) |
| Rehabilitation medical centers (clinic, hospital) | 16 (7.88) |
| Medical centers (primary, secondary, tertiary hospital) | 42 (20.69) |
| Type 2. Public health service (public health centers, community-based mental health centers, etc.) | 55 (27.09) |
| Community mental health welfare centers | 6 (2.96) |
| Public health centers: community-based rehabilitation teams | 13 (6.40) |
| Public health centers: visiting nursing teams | 36 (17.73) |
| Type 3. Social welfare and community service (social welfare centers, vocational rehabilitation facilities, assistive technology service centers, etc.) | 62 (30.54) |
| Social welfare centers for PWDs | 38 (18.72) |
| Residential homes for PWDs | 2 (0.99) |
| Day care centers for PWDs | 6 (2.96) |
| Vocational rehabilitation facilities for PWDs | 1 (0.49) |
| Social service centers (activity assistant or long-term care) | 6 (2.96) |
| Advocacy agencies for PWDs | 3 (1.48) |
| Family support centers for PWDs | 6 (2.96) |
| Type 4. Disability association | 28 (13.79) |
| Background of professionals | |
| Physicians | 2 (0.99) |
| Nurses | 38 (18.72) |
| Physiotherapists/Occupational therapists/Exercise Physiologist | 21 (10.34) |
| Social workers | 113 (55.67) |
| Formal caregivers | 1 (0.49) |
| Special educators | 1 (0.49) |
| Administrators/Public servants | 19 (9.36) |
| Technicians (environmental accessibility experts, assistive technology specialists) | 3 (1.48) |
| Disability advocates | 5 (2.46) |
Table 3
Awareness of Community Health and Social Care Organizations for PWDs, and Perceived Importance, Frequency, and Satisfaction with Collaboration with These Organizations.
| COMMUNITY HEALTH AND SOCIAL RESOURCES (n a) | AWARENESS N (%) | IMPORTANCE (M ± SD) | FREQUENCY (M ± SD) | SATISFACTION (M ± SD) | |
|---|---|---|---|---|---|
| Medical | b Primary health care teams for PWDs (n = 203, 14) | 84 (41.38) | 4.10 ± 0.82 | 1.12 ± 0.50 | 3.50 ± 0.76 |
| Rehabilitation medical centers (clinic, hospital) (n = 187, 68) | 139 (74.33) | 4.19 ± 0.79 | 1.61 ± 0.95 | 3.38 ± 0.65 | |
| Medical centers (primary, secondary, tertiary hospital) (n = 168, 80) | 132 (81.99) | 4.14 ± 0.76 | 1.81 ± 0.98 | 3.43 ± 0.76 | |
| b Disability-friendly health checkup facilities (n = 203, 7) | 43 (21.18) | 4.06 ± 0.88 | 1.04 ± 0.25 | 3.57 ± 1.13 | |
| Dental care centers for the persons with special needs (n = 203, 26) | 76 (37.44) | 4.11 ± 0.84 | 1.22 ± 0.64 | 3.69 ± 0.74 | |
| Public health | b Regional health & medical centers for PWDs (n = 203, 57) | 107 (52.71) | 4.22 ± 0.75 | 1.53 ± 0.99 | 3.91 ± 0.83 |
| Community mental health welfare centers (n =197, 91) | 14 (71.07) | 4.18 ± 0.86 | 1.75 ± 0.97 | 3.45 ± 0.75 | |
| Public health centers: community-based rehabilitation teams (n = 190, 41) | 86 (45.26) | 4.22 ± 0.84 | 1.40 ± 0.85 | 3.61 ± 0.70 | |
| Public health centers: visiting nursing teams (n = 167, 65) | 116 (69.46) | 4.24 ± 0.81 | 1.63 ± 0.97 | 3.52 ± 0.92 | |
| Social welfare | Social welfare centers for PWDs (n = 165, 143) | 148 (89.70) | 4.32 ± 0.75 | 2.75 ± 1.14 | 3.65 ± 0.77 |
| Residential homes for PWDs (n = 201, 79) | 161 (80.10) | 4.10 ± 0.83 | 1.67 ± 0.97 | 3.54 ± 0.66 | |
| Day care centers for PWDs (n = 197, 83) | 152 (77.16) | 4.14 ± 0.80 | 1.77 ± 1.06 | 3.59 ± 0.66 | |
| Vocational rehabilitation facilities for PWDs (n = 202, 81) | 157 (77.72) | 4.17 ± 0.78 | 1.72 ± 1.04 | 3.67 ± 0.67 | |
| Social service centers (activity assistant or long-term care) (n = 197, 115) | 159 (80.71) | 4.33 ± 0.74 | 2.38 ± 1.43 | 3.65 ± 0.66 | |
| Assistive technology service centers (n = 203, 85) | 145 (71.43) | 4.25 ± 0.78 | 1.93 ± 1.29 | 3.67 ± 0.71 | |
| Mobility support centers for the transportation vulnerable (n = 203, 99) | 165 (81.28) | 4.32 ± 0.83 | 2.09 ± 1.33 | 3.63 ± 0.78 | |
| Community service centers (n = 203, 141) | 176 (86.70) | 4.40 ± 0.75 | 2.71 ± 1.43 | 3.52 ± 0.74 | |
| Advocacy agencies for PWDs (n = 200, 49) | 106 (53.00) | 4.00 ± 0.84 | 1.45 ± 0.89 | 3.76 ± 0.72 | |
| Family support centers for PWDs (n = 197, 47) | 129 (65.48) | 4.15 ± 0.84 | 1.41 ± 0.81 | 3.49 ± 0.62 | |
| Disability association | Associations of PWDs (n = 175, 65) | 135 (77.14) | 3.89 ± 0.92 | 1.73 ± 1.11 | 3.48 ± 0.75 |
[i] a The total number of respondents for awareness, importance, and frequency of collaboration with each community resource. Respondents skipped these questions for their own affiliated organization. Satisfaction was only assessed among those with actual collaboration experience. For example, excluding 16 respondents affiliated with rehabilitation medical centers, 187 answered questions on awareness, importance, and frequency of collaboration with these centers, and 68 rated their satisfaction.
b The organizations newly established as part of a policy initiative designated by the Korean government under the Act on Right to Health for PWDs.
Abbreviations. PWDs = People with disabilities, N = number of respondents, M = Mean, SD = standard deviation.
Figure 1
IPA grid of community health partnership according to respondents’ organizational affiliation.
aa: Regional health & medical centers for PWDs; ab: Primary health care teams for PWDs; ac: Rehabilitation medical centers; ad: Medical centers; ae: Disability-friendly health checkup facilities; af: Dental care centers for the persons with special needs; ag: Community mental health welfare centers; ah: Public health centers-CBR team; ai: Public health centers-visiting nursing; aj: Social welfare centers for PWDs; ak: Residential homes for PWDs; al: Day care centers for PWDs, am: Vocational rehabilitation facilities for PWDs; an: Social service centers (activity-supporting, long-term care); ao: Assistive technology service centers; ap: Mobility support centers for the transportation vulnerable; aq: Associations of PWDs; ar: Community service centers, as: Advocacy agencies for PWDs; at: Family support centers for PWDs.
Table 4
Community resources on the “Concentrate here (high importance-low performance)” and “Low priority (low importance-low performance)” quadrants of IPA grid by respondents’ organizational affiliation types.
| AFFILIATION TYPE | CONCENTRATE HERE | LOW PRIORITY |
|---|---|---|
| Medical |
|
|
| Public-health |
|
|
| Social-welfare |
|
|
| Disability-association |
|
|
[i] b The organizations newly established as part of a policy initiative by Korean government under the Act on Right to Health for PWDs.
c (m). The community resources were categorized as medical facilities.
d (p). The community resources were categorized as public health agencies.
e (s). The community resources were categorized as social welfare and social service organizations.
f (d). The community resources were categorized as disability associations.
Table 5
Perceptions on intersectoral collaboration from an open-ended question.
| CATEGORIES | N (%) |
|---|---|
| Total respondents | 70 (100.0) |
| Information | 37 (52.86) |
| 1. Lack of information about community resources available for collaboration “Intersectoral collaboration is sometimes hindered due to a lack of awareness about how to engage with other agencies or what services are available for collaboration.” (Id 59) | 21 |
| 2. Absence of standardized guidelines and materials explaining services provided by each organization, including practical consulting or counseling guidance for inter-agency collaboration “I think there is a need for materials that can provide detailed information on the services a client can receive at each collaborating organization during inter-agency collaboration.” (Id 294) | 13 |
| 3. Information sharing platforms “I believe that if a platform is established where information about the services provided by each organization can be shared, it will help prevent the duplication of services and enable more efficient service delivery.” (Id 281) | 3 |
| Governance or Systems | 18 (25.71) |
| 1. Control tower, central hub, unified delivery system “Inter-agency collaboration is often carried out in a fragmented manner, resulting in gaps when establishing local networks. A hub organization that takes a leading role in coordinating and maintaining these networks would be beneficial.” (Id 75) | 7 |
| 2. Building a formal network system, referral system “There is a need to establish a formal system that enables seamless collaboration between the welfare and healthcare sectors. This would ensure that when a person with a disability is identified through welfare services, they can also be appropriately referred to and managed by relevant healthcare services.” (Id 159) “Establishing formal networks among community organizations can enhance communication among professionals. Over-reliance on informal networks, such as personal connections, risks weakening collaboration when the responsible personnel change.” (Id 64) | 11 |
| Administrative process | 12 (17.14) |
| 1. Complex and various procedures across the organizations “It seems that the procedures for inter-agency collaboration are complex, involve a large amount of paperwork, and differ between organizations.” (Id 216) | 11 |
| 2. Long waiting times “When referring clients to public health center services, the long waiting times often make collaboration difficult.” (Id 312) | 1 |
| Workforce | 22 (31.43) |
| 1. Staff shortage & turnover in collaboration roles “There is a shortage of staff specifically assigned to manage inter-agency collaboration. (…) Frequent staff turnover prevents continuous connections and makes information transfer challenging.” (Id 118) | 5 |
| 2. Staff competency and performance variability “There are differences in performance in collaboration between organizations depending on the job competencies of workers in intersectoral collaboration.” (Id 10) “It is necessary to regularly provide training to disability-related organizations on new government programs aimed at promoting the health rights and health improvement of people with disabilities, including introductions to these programs and guidance on how to access them.” (Id 30) | 4 |
| 3. Uncooperative or passive attitudes of staff “The uncooperative, passive attitude of some partner organizations makes intersectoral collaboration difficult. There was an experience where a referral was made to a mental health welfare center for a person with a developmental disability, but the referral was declined, as they stated that counseling was difficult.” (Id 38) | 13 |
| Resources | 15 (21.43) |
| 1. Shortage of available service resources “There seems to be an overall shortage of social services and local resources for rehabilitation services available for PWDs.” (Id 317) | 13 |
| 2. Limitations in financial and administrative support for intersectoral collaboration “When there are no additional incentives for collaboration, many organizations tend to respond passively.” (Id 231) | 2 |
| Clients | 5 (07.14) |
| 1. Sensitive to sharing information “When referring a client for inter-agency collaboration, the client is often sensitive about sharing their personal information.” (Id 2) | 2 |
| 2. Difficulties in explanation and persuasion “There is a tendency to rely heavily on the opinions of the client’s caregivers or representatives when determining the necessary services and appropriate organizations. As a result, professional opinions are often overlooked. It is challenging to obtain the client’s consent for inter-agency collaboration.” (Id 5) | 3 |