• Title/Summary/Keyword: 자가보험

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The Influence of Attitude toward the Elderly, Empathy and Job Stress on Quality of Service among Caregivers in Long-term Care Facilities (장기요양시설 요양보호사의 노인에 대한 태도, 공감, 직무 스트레스가 서비스 질에 미치는 영향)

  • Seong, Ji-A;Yeom, Eun-Yi;Lee, Jae-Hee
    • The Journal of the Korea Contents Association
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    • v.21 no.11
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    • pp.646-656
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    • 2021
  • This study examined effects of attitude toward the elderly, empathy and job stress on quality of service among caregivers in long-term care facilities. The participants were 133 caregivers in C province. Data were collected from May 1 to August 31, 2019 through self reported structured questionnaire. Data analysis was performed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and stepwise regression. Empathy correlated negatively with job stress and correlated positively quality of service. Attitude toward the elderly and job stress were negatively correlated with quality of service. Job stress, empathy and attitude toward the elderly explained 31.6% of variance in quality of service among caregivers in long-term care facilities. The findings indicate that caregivers' job stress, empathy and attitude toward the elderly are important factors to be considered for the improving quality of service among caregivers in long-term care facilities.

Clinical Characteristics and Adherence of Patients Who Were Prescribed Home Oxygen Therapy Due to Chronic Respiratory Failure in One University Hospital: Survey after National Health Insurance Coverage (한 대학병원에서 조사된 재택산소요법을 받고 있는 환자의 특성과 재택산소요법 처방에 대한 순응도: 건강보험급여전환 후 조사)

  • Koo, Ho-Seok;Song, Young Jin;Lee, Seung Heon;Lee, Young Min;Kim, Hyun Gook;Park, I-Nae;Jung, Hoon;Choi, Sang Bong;Lee, Sung-Soon;Hur, Jin-Won;Lee, Hyuk Pyo;Yum, Ho-Kee;Choi, Soo Jeon;Lee, Hyun-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.192-197
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    • 2009
  • Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

The Precaution Duty and the Product Liability for Adverse Reactions to the Contrast Media (조영제 부작용에 대한 주의의무와 제조물책임)

  • Kang, Yeong-Han
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.305-311
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    • 2007
  • Contrast medium is a useful drug for radiological examinations and usability of it gradually increases while it has some inevitable adverse reaction and it is difficult to predict the occurrence and the degree of adverse reactions. Although the patient consented permission for the use of contrast media, the hospital could not be exempted from the responsibility for the adverse contrast media reaction. During radiological contrast media examination, the radiologist and the contrast media producer have the duty of precaution, prediction and avoid adverse results. In addition, they have reliabi lity of patient remedy for neglecting the duty. Since contrast medium are manufactured or processed as movable properties, the manufacturers are bound to the product liability if damages occur due to the defects in pharmaceuticals. In consideration of the characteristics of product liability, it is necessary to demand high degree of duty of care and diligence from producer or to reduce patient's burden of proof in a product liability lawsuit. For securing compensation ability and liability implementation, products compensation liability insurance is required for contrast medium manufacturers. In conclusion, contrast medium producer has legal liability for adverse reactions and the contract concluded with producer and hospital including legal liability will reduce liability of hospital and radiologist, patient.

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The Educational Need of Forensic Medicine for Emergency Medical Technicians in 119 Rescue Service (119구급대 응급구조사에 대한 법의학교육의 필요성)

  • Kim, Byung-Yong;Lee, Sang-Han
    • Journal of forensic and investigative science
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    • v.2 no.2
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    • pp.50-66
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    • 2007
  • An Emergency Medical Technician (EMT) is a well-trained emergency responder to provide emergency medical services to the critically ill and injured patient. In various situations, EMT may destroy potential physical evidences associated with the crime scene or determination of real cause of death. This study was aimed to evaluate the educational need of forensic medicine in Korean EMT. Questionnaires were administered to 592 EMTs during March 2007. The response rate was 60.3%(357 EMTs). In questionnaires there were 13 questions regarding the general characteristics, 16 questions about roles of EMTs related with forensic circumstances, 9 questions about the education related to forensic medicine. Questionnaires rated on a 4-point Likert scale or 5-point Likert scale. Most of 119 rescue EMTs had experienced with situations related to crime or unexpected sudden death. EMTs had arrived to the scenes earlier than police and complained of some difficulties related with deficit of forensic knowledge. EMTs wanted to receive continuous educations about forensic medicine. In order to reduce dissatisfaction with EMTs roles and to improve crime scene preservations, Emergency Medical Services policies should provide regular educational curriculum by forensic pathologists and promote legal responsibilities for 119 rescue EMTs.

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NEED FOR DEVELOPMENT OF HOME HEALTH NURSING PROGRAM IN KOREA (가정 간호 사업에 관한 연구)

  • Ruth M. Virginia;Moon Jung Soon
    • Journal of Korean Public Health Nursing
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    • v.5 no.1
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    • pp.53-69
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    • 1991
  • 가정간호사업 도입에 대한 대상자의 필요성에 대한 인식을 알아보고자, 1988년 7월 1일부터 동년 8월말까지 서울시내 5개 대학병원에서 퇴원하는 환자 390명과 환자 보호자 380명, 주민 780명, 총 1550명을 대상으로 조사한 결과 다음과 같은 결론을 얻었다. 1. $81\%$의 대상자가 가정간호 사업 도입이 필요하다고 한 반면 $7.5\%$는 필요 없다고 하였으며, $11.5\%$는 잘 모르겠다고 하였다. 필요성 인식 율은 주민이 $83\%$, 환자보호자가 $79\%$, 환자가 $78\%$로서 세 집단 간에 유의한 차이 가 있었다. (P<.01). 인구학적 변수별로 보았을 때, 교육수준과 가정수입에 따라 인식 율에는 유의한 차이가 있어서 (P<.001, P<.01), 교육수준이 높을수록, 수입이 많을수록 높았다. 2. 필요성 인식 율은 가정간호사업 이용의사에 따라서도 유의한 차이가 있어서 (P<.001), 이용의사가 많은 군이 인식 율도 높았다. 3. 환자들의 필요성 인식 율은 퇴원시기에 대한 의견과 병원비 지출액에 따라 유의한 차이가 있어서 (P<.05, P<.02), 퇴원시기가 적절하다는 군이 부적절, 하다는 군보다, 또한 병원비 지출액이 적을수록 인식 율이 높았다. 진단명에 따라서는 피부 및 피하조직 진환$(100\%)$, 임신 및 출산에 관련된 합병증$(90\%)$, 신경 및 감각기계 질환$(85\%)$, 부상 및 중독$(83\%)$, 신생물$(79\%)$, 등에서 필요성 인식 율이 높았다. 4. 가정간호사업 이용에 대한 대상자의 의견을 $47.8\%$가 이용할 의사가 있었고, $49.9\%$는 상황에 따라 결정하겠다고 하였으며, $3.2\%$는 이용하지 않겠다고 응답하였다. 인구학적 변수별로 보았을 때, 연령별로는 노년층, 성별로는 남성이, 교육수준은 낮은 군이, 의료보험을 가진 군이 이용할 의사가 많았으며, 통계적으로 유의한 차이가 있었다. (P<.01, p<.001, p<01, p<.01). 5. 환자들의 가정간호사업 이용 의사는 퇴원시의 상태에 따라서 유의한 차이가 있어서 (P<.02), 상태 가 입원 시와 변화가 없거나 악화된 군이 이용할 의사가 많았다. 진단별로는 내분비계 질환$(63\%)$, 신생물$(57\%)$, 혈액 및 조혈기능 장애$(55\%)$, 부상 및 중독$(55\%)$, 등이 이용할 의사가 많았다. 6. 대상자들이 가정간호사업의 장점으로 생각하는 것은 환자의 심리적 안정$(66\%)$, 시간 절약$(57\%)$, 가족의 편이$(57\%)$, 환자 간호에 대해 배운다$(53\%)$, 질병 과정을 배운다$(51\%)$ 등이었다. 7. 대상자들이 가정간호사업의 단점으로 생각하는 것은 응급시에 대처하기가 어렵다$(49\%)$, 환자가 불안해 할 것이다$(41\%)$ 가정환경이 환장에게 부적합하다$(43\%)$ 등이었다. 8. 가정간호사업에서 수용할 수 있는 간호 업무로$50\%$ 이상의 대상자가 지정한 것은 활력징후측정, 경구 및 비경구 투약, 운동과 휴식지도, 개인 위생관리, 보건교육, 정신 심리 간호 등이었다. 9. 가정간호사업에 대한 지불방법은 $32.9\%$가 제공된 업무에 따라 지불해야 한다는 의견으로 가장 많았다.

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Factors affecting family Caregivers' Preference for Utilization of Community Eldercare Services (가족부양자의 재가복지서비스 이용의사에 영향을 미치는 요인에 관한 연구)

  • Song, Da-Young
    • Korean Journal of Social Welfare
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    • v.53
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    • pp.105-128
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    • 2003
  • This study examined the factors affecting family caregiver's preference for utilization of community care services among those who are caring for 65+ elderly parents, and aimed to show how social eldercare services would be settled in Korea. Help-seeking behavior model developed by Anderson and Newman(1973) was used to analyze the factors affecting their preference for utilizing the community care service among 283 family caregivers. Frequency, Chi-square, and Multinominal logistic analysis on SAS 6.12 was used. According to the results, about 90% of the family caregivers have preference for community and institute care services. In community care service, about a half comprise the preference with charge while the other without charge. However, about 90% of those for institute care service show their willingness to pay for the service. Also, a majority of caregivers like to rely on social eldercare service, rather than family as exclusively responsible, against long-term care for their elderly parents. Multinominal analysis demonstrates that use versus nonuse of community care services is primarily affected by predisposing factors(including age, carer-caree closeness, and familism) and need factors (including economic or psychological burden of eldercare, and additional role for family care). Enabling factors, such as family income level, economic support from other family members and siblings, and supportive care-helpers, are mainly associated with the preferences of free versus charge in service use. These findings provide some implications and suggestions for the development of social eldercare services in our aging society.

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The Present Situation, Problems, Improving Plans about the Establishment and the Operation of a Medical Association - Mainly on the Violations of the Rules Regulating Medical Institute's Opening - (의료협동조합의 의료기관 개설·운영 현황과 문제점 및 개선방안 - 의료기관 개설기준 위반을 중심으로 -)

  • KIM, JOON RAE;BAEK, NAM BOK;LEE, YOON HAK
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.227-261
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    • 2015
  • Cooperative associations are established in order to enhance the rights and the interests of their members and serve the local communities, and actually do much for the local society. And among these, consumer cooperatives are spontaneously founded, particularly in the spirit of mutual help, in order to promote the common welfare of the members. Meanwhile, because the current medical law qualifys noncommercial corporation to open medical institution, consumer cooperative and noncommercial- corporation cooperative which are established under the Cooperative Act have the right to do. However, though cooperative association should be founded for common interests of the members who are weaker parties of society, it became rapidly to be abused as means of circumvention of law. Especially as National Health Insurance Corporation stepped up the investigation and the collection of unfair profits against the hospital owned by non-medical personnel who are unable to establish a medical institution, setting up medical institutions as a roundabout way to avoid the restricts dramatically increased in number. In this study, we are going to introduce the current dualised normative system regulating the establishment of a medical cooperative association, and find a way to improve the system and make up for the week points. And we will look though the present situation about medical cooperative association's opening, operating, and closing, and review the normative and systematic improving plans.

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Systematic Improvement for Effective Operation of Long-Term Continuous Construction Contracts (장기계속공사계약의 효율적 운영을 위한 제도 개선)

  • Cho, Youngjun
    • Korean Journal of Construction Engineering and Management
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    • v.20 no.6
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    • pp.3-10
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    • 2019
  • The entire duration of the long-term continuous construction contract project cannot be expected when calculating the initial budget as the construction of the contract is carried out annually according to the budget composition. In addition, the statutes related to the defect liability and execution of contracts have not been established systematically in relation to the contract. Therefore, there are many problems at the actual construction site with regard to the defect liability or the performance of the contract in relation to the contract. In this study, the following improvement directions were presented for the efficient operation of the contracts: First, the defect liability is legal and should be specified in an Act rather than an enforcement decree. Second, if the parties to the contract vary in the following order in the contract, the special agreement should be specified in the enforcement decree. Third, in the event of an indirect cost due to the extension of the period of the long-term continuous work, the contingency items of the total project cost management policy should be utilized. Fourth, in the case of general construction contract conditions, clauses related to the purchase of the premium of the CAR, inspection, taking over, defect repair, and defect inspection shall be supplemented.

Effects of service quality to service satisfaction and decision making in elderly care facility (노인요양시설의 서비스품질이 서비스만족과 의사결정에 미치는 영향)

  • Kim, In;Shin, Hakgene
    • 한국노년학
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    • v.29 no.2
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    • pp.579-591
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    • 2009
  • The purpose of this study is what are the factors affecting decision making for selection of social welfare facility, esp., elderly care facility. The resident's selection for social welfare facility are relatively new terms in the Korean social work. To explore the factors, we employed an empirical study. The collected data was analyzed by using SEM(Structural equation modeling). As the results, the standardized regression coefficient of the hypothesis that the service quality will affect the service satisfaction is equal to 0.555(t=6.723, p<0.01) and the coefficient that the service satisfaction will affect the decision making is equal to 0.766. The absolute fitness of the SEM model shows χ2 = 580.151(d.f.=317, p-value=0.000) and RMSEA=0.063, so that the model is absolutely fit. Since CFI=0.915, the model is comparatively fit. Conclusively speaking, the hypothesis that service quality affects to service satisfaction was supported. The hypothesis that service satisfaction affects to decision making was also supported. By accounting for the results of the analysis, this study verified the service quality leading to service satisfaction is an important factor for resident to select a residential facility.

Psychosomatic Symptoms Following COVID-19 Infection (코로나19 감염과 그 이후의 정신신체증상)

  • Sunyoung Park;Shinhye Ryu;Woo Young Im
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.72-78
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    • 2023
  • Objectives : This study aims to identify various psychiatric symptoms and psychosomatic symptoms caused by COVID-19 infection and investigate their long-term impact. Methods : A systematic literature review was conducted, selecting papers from domestic and international databases using keywords such as "COVID-19" and "psychosomatic." A total of 16 papers, including those using structured measurement tools for psychosomatic symptoms, were included in the final analysis. Results : Psychiatric symptoms such as anxiety, depression, and somatic symptoms have been reported in acute COVID-19 infection, while long-term post-COVID symptoms include chest pain and fatigue. The frequency of long-term psychosomatic symptoms has been estimated to be 10%-20%. Factors contributing to these symptoms include psychological and social stress related to infectious diseases, gender, elderly age, a history of psychiatric disorders, and comorbid mental illnesses. It is suggested that systemic inflammation, autoimmune responses, and dysregulation of the autonomic nervous system may be involved. Conclusions : Psychosomatic symptoms arising after COVID-19 infection have a negative impact on quality of life and psychosocial functioning. Understanding and addressing psychiatric aspects are crucial for symptom prevention and treatment.