• 농촌의학ㆍ지역보건
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• 제47권1호
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• pp.1-13
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• 2022

Objectives: This study aimed to establish a linkage model involving regional responsible medical institutions after analyzing the existing conditions and deriving problems through qualitative analysis within the community care system. Methods: A total of 14 participants of this study were selected through the snowball sampling method, including 7 community care service providers and 7 service users. As for the research data, primary data were collected through interviews, and as a result of analyzing according to Aday&Anderson' model, a total of 5 catergories, 8 topics, and 22 sub theme were derived. Results: The problem derived from the interview is that division services are provided for each institution due to the absence of a key central institution of community care system, and users' commercial institutions is unclear. The second is the inconsistency between the needs and supply for community care, resulting in a possibility of delay in returning to the community after discharge. Based on these problems, it is necessary to unify it as an community care window of the Dong-community center. In addition, there is a need for public health centers to play an active role, and to establish a public-private joint system with the Health and Living Support Center to establish a model that can play a certain role. Conclusions: Therefore, based on the results of this study, it can be used as basic data when constructing community care model and applying it as an expanded model in the future.

• 지역사회간호학회지
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• 제15권2호
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• pp.209-217
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• 2004

Purpose: The purpose of this study was to construct the structure, process and outcome of community-based home care nursing service and to examine their validity. Method: There were two steps. The first step was developing the structure and process of community-based home care and the second was evaluating the outcome of community-based home care. Home care services were provided to 25 clients who had health problems. Data on these clients were analyzed. Result: According to Albrecht Model, in the developed structure and process of community-based home care, structure contained facility's philosophy, organization, delivery system, steering committee, office, equipments, medical instruments, the home care nurse and client of home care nursing. Process contained classification of client. nursing diagnosis and nursing intervention. The majority of clients were men (56%). The service was used mostly by people aged over 50 (82%). The most frequent nursing diagnoses were altered urinary elimination (23.2%). impaired skin integrity (21.8%) and risk for infection (17.6%). Nursing interventions included wound care (16.7%), tube care (15.1%) and catheter care (14.5%). Conclusion: Several strategies are suggested from this study: first, activate a referral system within the national health care system: second, increase public information on home care nursing: third, develop home care nursing services for elderly people: and fourth, construct a cooperation system between home care services and social welfare services.

• 가정∙방문간호학회지
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• 제29권1호
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• pp.5-17
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• 2022

Purpose: This study aimed to investigate the role of hospital-based home health nursing in community care by examining the institutional progress of hospital-based home health nursing and the current status of home health nursing in Korea. Methods: Korean research data, national statistical data, government press releases, and related laws were investigated to clarify the role of hospital-based home health nursing in community care. Results: Korean visiting medical care services, including hospital-based home health nursing, was not found to be sufficient nationwide. The supply of home health nursing did not increase due to the nature of the visiting services that required transportation time, poor profitability due to insufficient insurance fees, and increase in acute beds. Conclusion: The nature of the Korean medical environment and visiting medical care makes it challenging to establish a visiting medical supply system for community care. Therefore, hospital-based home health nursing is an important infrastructure for visiting medical care, and will be a valuable resource to link discharged patients returning to the community when moving health care services. Hence, laws and institutional supplementation to expand the role of home health nursing agencies nationwide are needed along with addressing the limitations in the supply of home health nurses.

• 한국보육지원학회지
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• 제8권4호
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• pp.231-250
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• 2012

본 연구는 일본 보육지원 정책의 형성과 변화과정 및 지역사회 맞춤형 보육지원 정책을 고찰함으로써 우리나라의 저출산 및 보육문제 해결을 위한 보육지원 정책을 수립하는데 시사점을 모색하고자 하였다. 이를 위해 일본 보육지원 정책의 형성과 중요 시책의 변화과정, 일본의 지역사회 맞춤형 보육지원 정책의 개요와 내용을 고찰하여 우리나라 보육정책에 주는 시사점을 도출하였다. 연구결과, 2010년 보육지원 정책의 개혁으로 실시되고 있는 일본의 지역사회 맞춤형 보육지원 정책에 대한 현황 등에 대한 분석을 통해 나타난 시사점은 다음과 같다. 첫째, 국가의 거시적이고 적극적 보육정책의 지원과 지역사회의 재정과 상황을 고려한 보육지원 제도의 체계적인 확립이 필요하다. 둘째, 국가와 지역사회가 연계하여 보육정책에 대한 재정적 지원을 위한 현물과 현금지원 등 보육지원 재원의 확충이 필요하며 지역사회 네트워크 구축을 통한 보육지원서비스가 이루어져야 한다는 것이다.

• 지역사회간호학회지
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• 제19권4호
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• pp.673-683
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• 2008

Purpose: This study was aimed to evaluate the performance of a community-based home care services model. Method: The subjects were 138 patients who have been enrolled during a 6 month's period, nursing records and nursing service bills. The data was collected by self report and chart review. The mean cost per visit was compared with those of hospitalization & clinic visit in the data from National Health Insurance Corporation. Result: A significant number of patients were bed ridden(63.8%) and unconscious (27.5%), and most of the patients had complex chronic diseases. Except nursing assessment, bed sore care was the most frequent nursing treatment(25.1%) in home care services. The mean cost per visit of home care services was 34,665 won, which was lower than those of hospitalization & clinic visit for medical aid. The patients were highly satisfied with the services by visiting nurse specialists. Conclusion: Community-based home care services provided cost-effective and satisfied services. Community-based home care services needs systematic supports to expand it's domain for promoting community health.

• 지역사회간호학회지
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• 제32권3호
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• pp.382-395
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• 2021

Purpose: The purpose of this qualitative study was to explore the transition experiences of the elderly from long-term care hospitals to their homes. Methods: The participants were eight elderly medicaid beneficiaries, who had been the subjects from the community care project in Korea. The data were collected with one-on-one interviews from April to November in 2020, and analyzed by phenomenological steps. Results: The seven themes derived in this study were 'Space to escape', 'Reliable supporter opened the way to discharge', 'Comfortable life at home', 'Obstacles to independent life', 'Struggling to live alone', 'Fence for community life', and 'Energizing in daily life' Conclusion: The results revealed the positive aspects of Community Care program in Korea. However, it is suggested that active communication between hospitals and community care institutions, and improvement of home environment to live in the community before discharge should be required. And system revision is needed to adjust activity in their home and support health problems of the elderly in the early stage of discharge. The results of this study can be referred to as the foundation of transitional care for the elderly.

• 가정∙방문간호학회지
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• 제13권1호
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• pp.46-53
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• 2006

Chunchoen Community Home Nursing Program (CCHNP) sponsored by Chuncheon City and Gangwondo Nurses Association was the first trial of community based home health nursing in Korea. The services have started since 1996. The purpose of the study was the evaluation CCHNP to establish standard of community based nursing program in Korea. The methods of evaluation were quantitative and Qualitative approaches. Evaluation for organization and management were conducted by the American Community Health Accreditation Program Standards With the result. several recommendations were suggested : It is necessary to expand the program to all the Gangwondo cities. And the liaison system is necessary between medical care facilities and community nursing home agency to establish the continuity of health care delivery system in home nursing program. Also it is necessary to set up the supporting system between community home nursing care agency and hospital home nursing department. Finally, the National Health Insurance should cover the cost of community home nursing care.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.94-105
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• 2022

Background: As South Korea enters an aged society, the government has emphasized the need for a soft landing of the older adults into the community after the acute and recovery periods under a national policy of "community care." However, the institutionalization of community rehabilitation services to implement this is insufficient. Japan had already entered an aged society when the Long-Term Care Insurance System was introduced in 2000. Thus, the case of Japan's institutionalization of the system is expected to have implications for us in supplementing a suitable system for the aged society. Objects: This study compared the institutionalization process of the Long-Term Care Insurance System in South Korea and Japan and the services currently being implemented in each country. Methods: To examine the institutionalization process and services of the system, related legal rules and regulations, government reports, and articles were reviewed. To examine the operation status of the system, statistical data provided by each country's government were analyzed. Results: Japan recognized the importance of community rehabilitation even before the enactment of Long-Term Care Insurance. Thus, community rehabilitation services, such as home-visit rehabilitation and health facilities, were already stipulated in the law. Under such institutional legacy, Long-Term Care Insurance was able to establish a service system, which balanced welfare and health-related services, including various types of services with enhanced rehabilitation functions. In South Korea, rehabilitation policies were not much considered in the process of institutionalizing the system; thus, it was composed mainly of services focusing on care and recuperation. Conclusion: In order to realize community care, rehabilitation services need to be developed in Long-Term Care Insurance System in various forms such as home-visit services, daily services, short stay, and facility services.

• 한국주거학회논문집
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• 제25권2호
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• pp.99-107
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• 2014

This study attempts to provide implications for developing more efficient and effective community-based support system with AIP perspective for the elderly in Korea. The main purpose of this study is to analyze Japan's community-based integrated care system that respond to the concept of aging in place (AIP) and its cases. In Japan, they have offered Community-Based Service since 2005, and the advanced system which include integrated support categories and consolidated community/local resources will started in 2015 by The revision of Long-term Care Insurance policy, 2012. The result of policy analysis and case studies are as follows: 1) The suggestion for ideal support system model promoted a relationship of multiple agents include private sectors even resident and senior and specified responsibility sharing, 2) the system proposed Not only health and medical care support, living care and residence are also addressed as a comprehensive support. and 3) the amount of available community resource is different by each local government, but the effort to get the understanding of community residents and to connect with a potential community resource is also essential aspect to set effective community-based support system.

• 지역사회간호학회지
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• 제9권1호
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• pp.163-180
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• 1998

The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.