# Situation: The public health nurse and the municipal health team plan and run a one-year hypertension control program for adults aged 40 years and older in the municipality. One objective was a 55% control rate among enrollees by year-end. The year-end data are: Overall control rate among enrollees: 60% Coverage in the town-center barangays: 85% Coverage in the upland barangays: 30% Cost per enrolled client: within the approved budget Which conclusion is BEST supported by these data?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627085  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: The public health nurse and the municipal health team plan and run a one-year hypertension control program for adults aged 40 years and older in the municipality.

One objective was a 55% control rate among enrollees by year-end. The year-end data are:
Overall control rate among enrollees: 60%
Coverage in the town-center barangays: 85%
Coverage in the upland barangays: 30%
Cost per enrolled client: within the approved budget
Which conclusion is BEST supported by these data?

## 보기

1. The program was not efficient, because its cost exceeded the budget
2. The program was effective, but it did not reach upland areas fairly **✔ 정답**
3. The program was not effective, because its objective was not met
4. The program was not relevant to the municipality's priority problem

**정답: 2**

## 해설

Effectiveness asks whether the objective was achieved: 60% is above the 55% target, so it was met. Equity asks whether services are distributed fairly according to need: coverage of 85% in the town center against 30% in the upland barangays shows an equity gap. The data say nothing against efficiency or relevance, so the next plan should add outreach to the upland barangays.

## 심화 해설

Effectiveness and equity are different questions
Program evaluation looks at a program from several angles. Effectiveness asks whether the objective was achieved. Equity asks whether services reached people fairly according to need. Efficiency asks how resources compare with results, and relevance asks whether the program addresses a priority problem. The data in this item answer two of these questions clearly. The objective was a 55% control rate, and the result was 60%, so the program was effective. Coverage, however, was 85% in the town-center barangays and only 30% in the upland barangays, which shows an equity gap. A program can meet its overall target and still fail to reach the people who need it most.

Reading each line of the data
The overall control rate is an effectiveness measure, compared against the stated objective. The two coverage figures compare subgroups of the population; a gap this wide between areas of similar need points to unequal access, possibly from distance, transport cost, or fewer outreach visits in the uplands. The cost per enrolled client stayed within the approved budget, which gives no evidence of poor efficiency. Nothing in the data questions relevance; hypertension control in adults is a recognized priority.

| Evaluation criterion | Question it asks | What the data show |
| --- | --- | --- |
| Effectiveness | Was the objective achieved? | 60% vs target 55%: met |
| Equity | Were services fairly distributed? | 85% vs 30% coverage: gap |
| Efficiency | Were results achieved at reasonable cost? | Within budget: no problem shown |
| Relevance | Does it address a priority need? | Not questioned by the data |

Why the other conclusions are not supported
Calling the program inefficient because cost exceeded the budget contradicts the data, which state cost was within budget. Calling it ineffective because the objective was not met misreads the numbers, since 60% is above 55%. Calling it irrelevant has no basis in any of the figures provided. Watch out! When an item gives a list of results, match each figure to the criterion it actually measures before drawing a conclusion; an overall success figure can hide a subgroup problem.

What the next plan should do
The evaluation conclusion should lead to action: the next plan should add outreach to the upland barangays. Options include scheduling regular blood pressure clinics at the Barangay Health Stations in the uplands, training barangay health workers there to measure blood pressure and track enrollees, and arranging medicine supply closer to residents. Monitoring coverage by barangay rather than only the municipal total lets the team see whether the equity gap is closing.

## 임상 시나리오

Program Evaluation CriteriaEffective overall, unequal in reach
Effectiveness: the control rate of 60% exceeded the 55% objective, so the objective was met.

Equity: coverage of 85% in town-center barangays against 30% in upland barangays shows services did not reach areas fairly.

Efficiency and relevance are not questioned by the data. The next plan should add outreach to the upland barangays.

CautionDo not judge a program only by its overall rate; always compare subgroups for equity.

## 핵심 개념

- **Effectiveness** — The degree to which a program achieves its stated objectives.
- **Equity** — Fair distribution of health services according to need across groups and areas.
- **Efficiency** — The relationship between the resources used by a program and the results it produces.
- **Coverage** — The proportion of the target population that actually receives a program's services.

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