• 보건행정학회지
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• 제15권2호
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• pp.1-15
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• 2005

The aim of this study was to compare medical cost of hospice care and that of conventional care during the last year of life, and identify factors that influenced the cost. From January to August 2003 592 terminal cancer patients receiving care from 5 hospice care units and 2 hospice care teams in general hospitals were enrolled to case group. Two hundreds and seventy two terminal cancer patients receiving conventional care from 7 general hospitals were enrolled to hospital-based control group, and 1,636 terminal cancer patients from 122 general hospitals located in same regions with the 7 hospitals were enrolled to community-based control. We used characteristics and medical cost from data of National Health Insurance Cooperation. Total medical cost per beneficiary in cases was about 10 millions won, 14.5 millions in hospital-based controls and 11.1 millions in community-based controls. The hospice care saved $45\%$ over the last year of life compared with hospital-based controls (p<0.0001). Saving of inpatient cost account for approximately $80\%$ of saving per beneficiary. Hospice care saved $29\%$ of medical cost per hospitalization day compared with hospital­based controls and $17\%$ compared with community-based controls (p<0.0001). Multiple regression analyses showed that hospice care significantly saved the medical cost. This study suggest that hospice care save medical cost compared with hospital-based control and community-based control. Most of saving of inpatient cost account for approximately $80\%$ of saving of medical cost.

• Korean Journal of Acupuncture
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• 제27권3호
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• pp.57-65
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• 2010

Objectives : The purpose of this study is to investigate for rhinitis of middle school students and to confirm the effect of oriental medical treatments on rhinitis. We proceeded with this oriental medical treatment programs in collaboration with community health center. Methods : We have given oriental medical treatment, such as herbal medicines(pillet type Gamisinicheongpye-um and ointment) and intradermal acupuncture therapy at Hapgok (LI4), Yeonghyang (LI20), Indang, Bi-ik points, to patients for 9 weeks. Results of this treatment program were evaluated on a 4-point-scale depends on symptoms ; 'severe ()', 'moderate (++)', 'mild (+)' and 'no symptom (-)'. Results : After oriental medical treatments, rhinitis symptoms (sneezing, rhinorrhea, nasal obstruction, nasal itching and dysosmia) were improved significantly compared to before treatments (p<0.05). Conclusions : We confirmed rhinitis treated with oriental medicine should significant improvement and suggest that it is necessary to expand oriental medical treatment programs in collaboration with community health center.

• 우울조울병
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• 제16권3호
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• pp.152-157
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• 2018

Objectives : The purpose of this study was to examine psychosocial factors influencing suicidal ideation of community dwelling elderly, using the senior community center in Jeonnam Province. Methods : A total of 2,202 subjects (369 males, 1,833 females) were recruited. We evaluated sociodemographic factors, using a self-reporting questionnaire. Subjects completed the Geriatric Depression Scale-Short Form Korean Version (SGDS), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean version of the General Health Questionale-12 (GHQ-12) and Satisfaction with Life scale (SWLS), to assess psychosocial factors affecting suicidal ideation. Results : Among 2,202 subjects, 179 (8.1%) reported recent suicidal ideation. Self-perceptive health status (p<0.001) and physical disease (p=0.002) revealed differences between two groups. The scores of four scales in the suicidal group were significantly different from the control group: SGDS (p<0.001) and GHQ-12 (p<0.001) were higher, while MSPSS (p<0.001) and SWLS (p<0.001) were lower, in the suicidal ideation group than the control group. Multivariate logistic regression analysis revealed that physical disease (OR 2.575, 95%CI 1.022-6.492), SGDS (OR 1.181, 95%CI 1.120-1.246) and GHQ-12 (OR 1.192, 95%CI 1.108-1.283), were significantly associated with suicidal ideation. Conclusion : Findings support that physical disease, depression, and general mental health may correlate to suicidal ideation in the elderly.

• 대한임상독성학회지
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• 제13권1호
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• pp.25-32
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• 2015

Purpose: The aim of this study was to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between March and December 2013 at the academic ED at the tertiary urban hospital. During the study period, the pre-designed registry was recorded. The variables examined included the following: patients' demographic data (Sex, age, address, type of insurance, marital status, level of education, and history of previous psychiatric disease), suicide-related data (suicidal methods, combined drink of alcohol and number of previous attempts), and management-related data (disposition at ED, physician's training level, etc.). Univariated and multivariated logistic regression analyses were performed for identification of factors affecting the registration rate for the community-based post suicidal care program. Results: A total of 163 suicides were included during the study period. Of these, 33 (20.2%) patients were registered in the post-suicide care program. Factors including a patient's address (OR: 14.92, 95% CI: 3.606-61.711), immediate intervention by psychiatric healthcare center (OR: 5.05, CI: 1.688-15.134), admissions in hospital (OR: 3.69, CI: 1.286-10.605), and history of previous psychiatric disease (OR: 3.52, CI: 1.216-10.201) showed significant association with registration for the program. Conclusion: The community-based post-suicidal care program, which is available 24 hours a day, should be operated in each district in order to increase the registration rate. Emergency physicians should actively consider the inpatient treatment program for suicidal patients and strongly recommend registration to the program, particularly for patients without previous history of psychiatric disease.

• 대한간호학회지
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• 제45권5호
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• pp.742-751
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• 2015

Purpose: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. Methods: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Results: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. Conclusion: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

• 사회복지연구
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• 제42권2호
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• pp.303-322
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• 2011

만성질환보유 저소득 노인의 삶의 질 향상과 의료비절감을 위해서는 지역사회 보건복지서비스와 병의원서비스간의 연계가 중요하다. 본 논문은 서울시 복지패널데이터를 이용하여 병의원 의료서비스와 지역사회 보건복지서비스간의 연계 욕구 및 실태를 분석하기 위하여 병의원서비스 이용경험이 지역사회 보건복지서비스 이용(욕구)에 미치는 영향을 로짓분석하였다. 분석결과 입원경험이 있는 노인들은 입원경험이 없는 노인에 비해 지역사회 보건복지서비스에의 욕구가 더 높음에도 불구하고 실제로 해당 서비스를 더 많이 받지 못하고 있었다. 또한 외래이용경험이 없는 저소득 만성질환노인은 외래경험이 있는 노인에 비해 지역사회 보건서비스에의 욕구는 더 높았으나 실제 이용률은 더 높지 않았다. 결론적으로 볼 때 우리나라 병의원 의료서비스와 지역사회 서비스간의 연계가 긴밀하게 이루어지지 않고 있음을 알 수 있다.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1994년도 교수 연수회(역학)
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• pp.196-200
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• 1994

• 지역사회간호학회지
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• 제14권2호
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• pp.211-222
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• 2003

Purposes: The purposes of this descriptive correlational study were to assess knowledge and attitude toward smoking and smoking cessation counseling activity among nurses in a community, and to identify predictors of their smoking cessation counseling activity. Method: Nurses employed by institutions such as university hospital, hospital, clinic, and health department in a community were surveyed using a structured questionnaire. Of the nurses invited to participate in this study, 760 (88.5%) responded with completed questionnaires. Results: Nurses had relatively positive attitude toward their roles and responsibilities about smoking cessation counseling activity. However, smoking cessation counseling activity was not a routine part of their nursing practice. Moreover, the level of engagement with smoking cessation counseling activity was significantly different by working place. Nurses who were working at the university hospital, hospital, and health department were more actively engaged with smoking cessation counseling activity than nurses who were working at the clinic. Smoking cessation counseling activity was significantly correlated with knowledge of smoking. attitudes toward smoking-related issues, and self-efficacy for smoking cessation counseling activity. In the final stepwise multiple regression, smoking cessation activity was predicted by the nurses' working place, attitudes toward smoking-related issues, and self-efficacy for counseling knowledge and skills. Conclusion: In conclusion, nurses need to participate routinely and actively in smoking cessation counseling activity. To help nurses counsel and intervene patients regarding smoking cessation more effectively, it is essential to integrate educational information on smoking cessation intervention into curriculums of nursing schools as well as to offer smoking cessation intervention as a continuing education program available for currently practicing nurses.

• 융합정보논문지
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• 제10권1호
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• pp.195-202
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• 2020

본 연구는 바이오피드백 시스템을 활용한 하지 근력 강화 운동이 지역사회기반 노인에게 어떠한 영향이 있는지 알아본 연구이다. 지역사회기반 노인 10명을 대상으로 주 3회, 6주 동안 바이오피드백 시스템(기능적 전기 자극 동반)을 활용하여 운동을 실시하였다. 데이터 분석은 Wilcoxon signed rank test를 사용하였다. 본 연구 결과 신체 기능은 유의하게 좋아졌으나 근력 및 근육량에서는 유의한 차이가 없었다. 노인들도 지역사회기반 ICT 활용 가정 바이오피드백 훈련이 가능하며, 하지 기능 개선을 유도할 수 있음을 확인할 수 있었지만, 대상자수 확대, 성별 구분, 개인 맞춤형 훈련 방식 제공 등으로 보다 명확한 효과를 입증할 수 있도록 추가적인 연구가 필요하다.

• 한국농촌간호학회지
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• 제14권1호
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• pp.17-22
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• 2019

Purpose: This study was done to describe a community health practitioner's nursing case study for a hypertension patient. Methods: For this purpose, data were collected through interviews and nursing records. The nursing process was carried out from January to March in 2019. Results: For this patient, blood pressure was checked 5 times and total cholesterol test was performed 5 times over 41 consultations. Even though the patient was 84 years old, he was very interested in health. When the blood pressure and cholesterol level measured by community health practitioner were high, he was embarrassed by the recommendation to get a hospital checkup. After referral to a medical clinic and hospital, he was satisfied with the results of the tests and medical treatment, and constantly practiced daily walking exercise. Conclusion: It is very important for community health practitioners to assess patient symptoms correctly and refer the patient timely to manage complications.