• 가정간호학회지
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• 제10권1호
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• pp.5-14
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• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• 대한간호
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• 제25권2호통권135호
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• pp.72-79
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• 1986

The present health system with its emphasis on the patient in hospital and with specialized medical services, is not equipped to provide health maintenance and preventive care to society. Community generated medical facilities to provide preventive and lo

• The Journal of Korean Physical Therapy
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• 제32권4호
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• pp.266-271
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• 2020

Purpose: A survey was conducted to investigate the role, priority, and awareness of physical therapists in the community care system for the elderly. Methods: Nine hundred ninety-three physical therapists were invited to an online survey from 1st to 30th June 2020. Results: While the awareness of physical therapists for the community care system for the elderly was found to be low, the role priority and performance ability were found to be high. Fall training scored the highest for the job duties of physical therapists, and functional training scored the highest for the performance ability of physical therapists. For the role priority by the education status regarding the community care system, the participants who received the education program showed higher scores in the performance ability than those who did not. For the role priority and performance ability according to the education levels, higher education levels resulted in higher scores in both outcomes. Regarding the clinical experience, low scores were found in the participants with less than five years of experience. Conclusion: Physical therapy establishes itself as an essential area of expertise in the community care system for the elderly. Therefore, these results can be utilized in developing a model for Korean community care for the elderly.

• 지역사회간호학회지
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• 제33권4호
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• pp.357-371
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• 2022

Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

• 대한간호학회지
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• 제46권1호
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• pp.118-127
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• 2016

Purpose: The study purposes were to construct and test structural equation modeling on the causal relationship of community residents' perceived quality of care, image, and role performance with satisfaction, intention to (re)visit and intention to recommend hospital. Methods: A cross-sectional survey was conducted with 3,900 community residents from 39 district public hospitals. The questionnaire was designed to collected information on personal characteristics and community awareness of public hospitals. Community awareness consisted of 6 factors and 18 items. The data were collected utilizing call-interview by a survey company. Research data were collected via questionnaires and analyzed using SPSS version 20.0 and AMOS version 20.0. Results: Model fit indices for the hypothetical model were suitable for the recommended level: ${\chi}^2=796.40$ (df=79, p<.001), GFI=.93, AGFI=.90, RMSR=.08, NFI=.94. Quality of care, image, and role performance explained 68.1% of variance in community awareness. Total effect of quality of care process factors on satisfaction (path coefficients=3.67), intention to (re)visit (path coefficients=2.67) and intention to recommend hospital (coefficients=2.45) were higher than other factors. Conclusion: Findings show that public hospitals have to make an effort to improve community image through the provision of quality care, and excellent role performance. Support for these activities is available from both Central and Local Governments.

• Journal of Community Nutrition
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• 제6권3호
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• pp.141-145
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• 2004

The purpose of this study was to explore the relationship between life style and metabolic syndrome. The cross-sectional survey was conducted in Pingliang community in Shanghai in Jan 2003. The data was collected by questionnaire, and the results were analyzed by SPSS. It was found that the prevalence of Metabolic Syndrome (MS) was $13.4\%$ in the community, and the body mass index (BMI), waist-to-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum triglyceride (TG), total cholesterol(TC), low density lipoprotein-cholesterol (LDL-C), and fast plasma glucose (FPG) in MS group were higher than that in non-MS group. Logistic regression analysis indicated that BMI and WHR were positively correlated to the prevalence of MS, and physical activity was negatively correlated to the prevalence of MS. People with higher education levels (${\geq}10y$) had lower BMI, SBP, DBP, LDL-C and FPG. The prevalence of MS in the higher education level group was significantly lower than that of the lower education level group. These results suggested that BMI, WHR and physical activity were important factors of MS, and education background played an important role in the occurrence of MS. Therefore, it is very important to build a healthy life style for preventing and controlling the incidence and developing of MS.

• 대한지역사회작업치료학회지
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• 제4권1호
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• pp.1-10
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• 2014

목적 : 본 연구의 목적은 지역사회와 시설에 거주하는 뇌졸중 환자의 시간 사용과 삶의 질을 비교 분석하고자 한다. 연구방법 : 연구 대상은 요양병원에 입원 중이거나 외래로 재활치료 중인 뇌졸중 환자 74명을 대상으로 하였다. 일반적 특성, 작업 설문지(Occupational Questionnaire: OQ), 뇌졸중 환자 삶의 질(Stroke Specific Quality of Life: SS-QOL) 평가를 통해 조사하였고, 대상자 선정 기준에서 부적합한 8명을 제외한 총 66명을 대상으로 비교 분석하였다. 결론 : 거주 환경에 따른 시간 사용을 비교 분석한 결과 일상생활(p<.05), 휴식(p<.05)에서 유의한 차이가 있는 것으로 분석 되었다. 또한 삶의 질은 가족(p<.05), 자조관리(p<.05), 사회적 역할(p<.05)에서 유의한 차이가 있는 것으로 분석되었다. 결론 : 지역사회 거주 뇌졸중 환자가 시설 거주 뇌졸중 환자보다 일상생활과 휴식에 소비되어지는 시간을 효율적으로 사용을 하였고, 삶의 질 또한 높은 것으로 나탔다.

• 한국병원경영학회지
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• 제23권3호
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• pp.1-15
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• 2018

Purpose: This study is conducted to identify the impacts of tax exemption on community benefit, policy, human resource management, and public benefit. Based on the results of analysis, we explore several avenues to raise public benefit that is central to the value of existence of non-for-profit hospitals in Korea. Methodology: Survey was formulated referring to the US IRS tax exemption criteria, Form990/Schedule H, and Korean public hospital criteria. A total of 182 survey responses were collected and used to verify measurement validity and perform reliability analysis, confirmatory factor analysis, and path analysis. Findings: The result of this study showed positive relationships among; i) tax development and planning, ii) planning and human resource management, iii) human resource management and policy, iv) policy and community benefit, v) community benefit and public benefit. Practical Conclusion: Tax exemption affects community benefit and public benefit directly as well as indirectly. This implies that expanding tax exemption is likely to improve public benefit mediating community benefit.

• Journal of Preventive Medicine and Public Health
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• 제29권4호
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• pp.831-842
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• 1996

Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.

• 대한임상검사과학회지
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• 제45권2호
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• pp.43-47
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• 2013

This study was designed to evaluate the prevalence of ESBL genes and monitor antimicrobial resistance pattern in Escherichia coli, isolated from a hospital and a community. We tested 200 E. coli strains isolated in the hospitals and community in Chungcheong area from January to March 2012. Antimicrobial susceptibilities were tested by using the disk diffusion method. A search for ESBL genes was conducted by PCR amplification, and the genotypes were determined by direct nucleotide sequence analysis of the amplified products. An Epidemiologic study was performed by repetitive extragenic palindromic sequence-based PCR (REP-PCR). The percentage of ESBL-producing isolates was 17% for hospital associated E. coli and 11% for community associated E. coli. The ESBL gene sequencing results showed that the most common ESBL in E. coli was CTX-M-14 (19/28), followed by CTX-M-15 (9/28). The REP-PCR study also showed the genetic diversity, but there was no difference between the hospital and community associated E. coli. In this study, the most common types of class A ESBLs identified were CTX-M in the hospital and the community in Chungcheong area. ESBL-producing E. coli isolates showed diverse clonality.