• Journal of Convergence Society for SMB
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• v.6 no.4
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• pp.123-129
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• 2016

This study was conducted to understand influential factors in determining the advance directive attitudes of elderly patients. Structured survey questionnaires were distributed using a convenience sampling method to the residents of long-term-care facilities. As a result, the attitudes toward advance directives were accounted having 2.84 points, the functions of a family with 2.73 points, and the level of self-efficacy with 3.45 points. Participants who have higher family functions were found to have negative attitudes toward self-efficacy, as the relationship between two variables were in the negative correlation (r =-.324, p<.01). However, participants who have higher self-efficacy showed positive attitudes toward advanced directives as the two variables were in the positive correlation (r =.340, p<.01). This study will contribute to the settlement of the AD in Korea.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.3
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• pp.1920-1927
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• 2015

This study examined health insurance costs of occupational therapy in stroke patients. The subjects were stroke patients, who underwent occupational therapy by hospitalization or out-patient centers in 2010. The cost of occupational therapy was analyzed from the insurance claims data of Health Insurance Review and Assessment Service in 2010. The kinds of occupational therapy were divided according to the insurance fee of occupational therapy in 2010. In-patients who received occupational therapy paid the highest rehabilitation treatment fee, whereas outpatients paid the highest nervous system function test fee. The cost of occupational therapy in the special rehabilitation treatment fee was highest by 25.3 billion won. The number of uses of general hospitals was the highest by 180 thousand but the total cost of long-term care hospital was highest by 10.4 billion won. The number of uses and cost by regional groups was highest in Seoul and Gyeonggi-do province. This study is meaningful in that a cost analysis of occupational therapy in stroke patients was performed for the first time using the stroke data from the whole country. The result can be used to provide basic data to improve the insurance fee in the future.

• The Journal of Korean society of community based occupational therapy
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• v.4 no.1
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• pp.1-10
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• 2014

Objective : The purpose of this study was to comparatively analyze time use and quality of life in stroke patients who use Local community or convalescent Hospital environment. Methods : The study subjects were 74 stroke patients who were admitted to convalescent Hospital or who were being rehabilitated as outpatients. The Occupational Questionnaire(OQ)was used for measuring time use and the Stroke Specific Quality of Life(SS-QOL) utilized to measure Quality of life. Excluding 8 patients who did not fit selection criteria, 66 patients were selected and analyzed. Results : After comparatively analyzing time use in Local community and convalescent Hospital environment, significant differences were found in daily living(p<.05), resting(p<.05). In addition, in quality of life, significant differences were found in family(p<.05), self-management(p<.05), and social roles(p<.05). Conclusion : Local community patients used their time in daily living, resting more efficiently than convalescent Hospital patients, and also had a higher quality of life.

• Journal of Society of Occupational Therapy for the Aged and Dementia
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• v.12 no.2
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• pp.47-55
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• 2018

Objective : The purpose of this study is to consider the change of hand function according to the quality of sleep and to find out a correlation among the quality of sleep and hand function, and sleep disturbing factors. Method : 23 patients who were hospitalized more than 6 months from Nov. 2017 to Jan. 2018 were tested for the quality of sleep used by sleep quality scale, for the grip strength used by a dynamometer, and for the coordination used by BBT and 9-Hole Peg test. The collected data were analyzed to implement the paired t-test and Pearson correlation coefficient. Result : In the high grade group of sleep score, the quality of sleep & BBT, and the grip strength & BBT have correlated each other; and in the medium group, only the latter has shown a correlation. In both groups, the quality of sleep and the sleep pattern have showed significant high correlation. Conclusion : When the elderly in geriatric hospitals show qualitative differences, BBT and the combination of treatment for the improvement of grip strength can improve the quality of sleep. And the sleep pattern intervention is considered to be effective to improve the quality of sleep.

• Journal of the Korea Convergence Society
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• v.8 no.12
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• pp.119-127
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• 2017

This paper convergent examined caregiver burden, depressive symptoms and health related quality of life of 226 caregivers of stroke patients, who had been hospitalized in 7 general hospitals located in Cheongju and Daejeon Metropolitan city. The quality of life was measured using SF-8, which is a short version of HRQoL. According to Multiple regression Analysis, dependence of a patient were important factors in the physical related quality of life. These results suggest that in order to improve the quality of life related to the physical health of the stroke patient's caregiver, the elderly long-term care insurance system and the caregiver system and the ward of the Ministry of Health and Welfare are expanded ward without a caregiver. There is a need to raise expectations for recovery through education and family support groups.

• Journal of muscle and joint health
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• v.18 no.2
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• pp.215-226
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• 2011

Purpose: This study aims to investigate the fear of falling of stroke patients and identify factors affecting the fear of falling. Method: For basic data, structured questionnaires were used for 137 stroke patients in hospitals in B city sampled for this study from June to August, 2010. Results: A multiple regression analysis used to identify variables affecting the fear of falling of stroke patients indicates that the most affecting variable was activities of daily living (${\beta}$=-.558), followed by self-efficacy of falling (${\beta}$=-.223), primary caregiver (${\beta}$=-.118), perception of health (${\beta}$=-.128) and drunken status (${\beta}$=-.108). Total variance explained by activities of daily living, self-efficacy of falling, the primary caregiver, perception of health and drunken status was 81.2% (F=70.845, $R^2$=.812). Conclusion: As discussed above, the factors significantly affecting the fear of falling in stroke patients were activities of daily living and self-efficacy of falling. Therefore, in order to reduce fear of falling of stroke patients and prevent falling, it is suggested that programs should be developed that will improve self-efficacy of falling and daily living activities.

• The Korean Journal of Health Service Management
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• v.7 no.1
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• pp.167-177
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• 2013

This study was to evaluate the influences of swallowing function on quality of life and activity of daily living of inpatients in geriatric hospital. The subjects were consisted of elderly patients over the age of 65, 50 people in geriatric hospital of gwangju and jeonnam area. The results are as follows: First, swallowing function score of the subjects is $29.90{\pm}5.27$, SWAL-QOL score is $158.12{\pm}33.36$, ADL score is $80.40{\pm}22.91$. Second, swallowing function, SWAL-QOL details and ADL details of each other showed a statistically significant correlation. Third, the items of swallowing function affecting on quality of life are 'oral cavity in residue', 'to eat solid food', and 'phlegm obstructs the throat'. In conclusion, this study showed that swallowing function of inpatients in geriatric hospital is closely associated with the quality of life and the activity of daily living. Therefore, future development of programs for the improvement of swallowing function is required in order to improve the quality of life of inpatients in geriatric hospital.

• The Korean Journal of Health Service Management
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• v.7 no.1
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• pp.133-144
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• 2013

The present study is aimed at assessing medical service quality as perceived by in-patients of geriatric hospitals and at analyzing the excitement factors by using revised IPA Applying the Kano's model for users' satisfaction. The data was collected from Nov. 5 to Dec. 7, 2012. Among a total of 503 cases of questionaries, only 419 cases were used. To data were analyzed by PASW statistics 18.0 and revised IPA applying Kano's model. The paired t-test results reveal that satisfaction was higher than the expectation level at a statistically significant level across all the medical service quality factors. The revised IPA results categorized facility convenience, hospitalization and care, and kindness as basic factors and medical reliability and access as excitement factors. In conclusion, medical reliability and access, which were identified as excitement factors of medical service quality, are essential opportunity factors for users and should accordingly be used as strategic factors to increase satisfaction with a geriatric hospital and induce customer surprise.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.145-153
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• 2016

Purpose: This study was conducted to investigate patients' characteristics and actual conditions of home-based services offered by a free-standing hospice center. Methods: A retrospective review was performed with the medical records of 75 patients who received home-based hospice care from a free-standing hospice center from January 2014 through December 2014. Results: Most patients (54.7%) were enrolled via self-directed referral. The reason for the service termination was death at home 25.3%, admission to a hospice ward 50.7%, hospitalization 22.6% and patients' refusal 2.7%. Seventy three patients had cancer, and two patients had ALS. Among all, 58.7% were in a dying phase, and 34.7% were almost completely bedfast at the time of their enrollment in this study. When they enrolled, the patients' physical symptoms were characterized as pain (89.4%), sleep disturbance (71.2%), urinary difficulties (35.8%) and defecation difficulties (47.8%). Among all, 77.4% terminated the home visit service within one month. The mean frequency of the home visits was 3.25 (${\pm}3.98$), and less than five in 82.7% of patients. The mean frequency of the phone service was 3.40 (${\pm}3.12$). The frequency of doctor's home visits was $1.21{\pm}0.79$ on average, and the figure increased when patients' conditions turned unstable. Conclusion: It is necessary to develop a home-based hospice care model with consideration of patients' characteristics and the actual service conditions delivered by free-standing hospice facilities.

• Health Policy and Management
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• v.31 no.2
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• pp.173-179
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• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.