• Journal of the Korean Dietetic Association
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• v.20 no.3
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• pp.199-211
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• 2014

The increasing elderly population has created an urgent need for well-managed convalescent hospitals, which should provide appropriate clinical nutrition services. The new accreditation policy requiring participation of all convalescent hospitals since 2013 may promote improvement of clinical nutrition services. This study examined whether or not the accreditation policy has increased practice level and dietitians' perception of the importance of clinical nutrition management. Of the 177 convalescent hospitals accredited by January 30, 2014, dietitians from 73 hospitals (41.2%) completed the survey questionnaire. The pre-tested questionnaire surveyed general characteristics of the hospital and dietitians, current status of clinical nutrition management, and changes in the perception and practice levels of various aspects of food and clinical nutrition management. In average, dietitians with more than 5 years of work experience (68.1%) provided food and clinical nutrition services (71.2%). After accreditation, dietitians' perception of the importance and practice level of clinical nutrition service increased (P<0.001). Level of perception, however, was significantly (P<0.001) higher than practice level before and after accreditation. During perception and practice level of initial nutrition assessment, a compulsory accreditation item, notably and significantly (P<0.001) improved after accreditation. The significant difference between perception and practice level disappeared after accreditation. In conclusion, the accreditation process had positive effects on clinical nutrition management in terms of dietitians' perception and practice levels. Making more accreditation items compulsory and providing motivation and professional education to dietitians in convalescent hospitals could lead to additional improvements.

• Health Policy and Management
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• v.33 no.1
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• pp.40-54
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• 2023

Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, 'rho' values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion: The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.11
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• pp.324-334
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• 2019

This study investigates the characteristics of patients hospitalized at a convalescent hospital, by considering patient groups based on their medical record information. It further analyzes and correlates the factors, thus providing basic data required to improve the patient classification system at convalescent hospitals. The data includes total information of 213 medical records of patients discharged from a convalescent hospital in the Jeonbuk region during a period of one year, from January to December 2016. The study examines and correlates the days of hospitalization and the number of diseases, revealing a positive correlation having a correlation coefficient, thereby indicating that infliction with a greater number of diseases results in longer hospitalization. Based on these findings, the study raises the need to revise and supplement items on the patient assessment report to help determine the patient groups and identify medical efforts to be actually provided to patients. In addition, a proper care service system for each patient group based on their respective problems that are intensively managed according to the patient groups will be an essential element in the efficient management of convalescent hospitals. Furthermore, an important task addressed will be in managing the health of the elderly population at the national level.

• The Korean Nurse
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• v.7 no.4 s.36
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• pp.66-69
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• 1968

• Journal of Society of Preventive Korean Medicine
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• v.17 no.3
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• pp.115-128
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• 2013

Objectives : This study was aimed to investigate burn out degree of K.M.D.s(Korean medicine doctors) who work at convalescent hospitals and to find contributional factors for the result. The relationship between burn out and job performance was also studied. Methods : 77 K.M.D.s(Male 49(63.6%), Female 28(36.4%)) participated in this survey that has 62 main questions about burn out, job performance, job environment and Social demographic characteristics. Survey was conducted from 19th Aug. 2013 to 6th Nov. 2013. Results : Average of burn out degree of K.M.D.s was 2.62 out of 5. Emotional exhaustion was highest (2.80) and depersonalization was lowest(2.20) among subordinate concepts of burn out. Work place location and average income of the subjective which are subordinate concepts of social demographic characteristics showed significant correlation with job performance. Role conflict, relation of co-worker, workload were significant factors for emotional exhaustion and meaning of the job, will of patient, challenge were significant factors for lack of feeling of accomplishment by multiple regression analysis. Relation of co-worker, aggression of patient and meaning of the job were also significant factors for depersonalization. Conclusion : Emotional exhaustion and lack of feeling of accomplishment among subordinate concepts of burn out were high in the subjective who participated this study. Significant factors that contribute to burn out of this study, shows different result compare to the studies that show other factors contribute to burn out who works at convalescent hospital or other place.

• IMMUNE NETWORK
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• v.2 no.4
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• pp.202-207
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• 2002

Background: Kawasaki disease is an acute febrile illness with systemic vasculitis which primarily affects children, We examined the production of leptin in plasma and gene expressions of CXC chemokines in peripheral blood mononuclear cells from patients with Kawasaki disease. Methods: Consecutive 39 samples from 13 patients according to the different clinical stages (acute, subacute, convalescent) of Kawasaki disease were collected. The plasma leptin levels according to clinical stages of Kawasaki disease were examined by ELISA and the expression of IP-10, Mig and IL-8 mRNAs in 39 samples (13 samples of each stage) from 13 cases were examined by RT-PCR. Results: There were not significant changes of plasma leptin levels according to the clinical stages of Kawasaki disease. The mean values of plasma leptin concentrations during each of the stages (n=13, p>0.05, pg/ml) were $335.8{\pm}549.0$ in acute, $358{\pm}347.6$ in subacute, and $443.6{\pm}645.9$ in convalescent stage. The mRNAs of IP-10, Mig, and IL-8 were expressed in 13/13 (100%), 2/13 (15%), 9/13 (69%) during acute stage, 13/13 (100%), 6/13 (46%), 13/13 (100%) during subacute stage, and 13/13 (100%), 4/13 (31%), 10/13 (77%) during the convalescent stage, respectively. In three patients, the production of leptin and expression of IP-10 mRNA were dramatically decreased according to the process of the clinical stages. In five patients with prominent cervical lymphadenopathy, the expression of IL-8 mRNA during the subacute stage was more elevated than the acute and convalescent stages. Conclusion: This data suggests that the production of leptin and the gene expressions of IP-10, Mig and IL-8 seem to have no significant correlation to the clinical stages of Kawasaki disease. However, expression patterns of IP-10, Mig and IL-8 mRNA may be related to the specific clinical manifestations, and the expression of IP-10 may also be correlated to leptin levels with pericardial involvement.

• The Journal of Korean Physical Therapy
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• v.34 no.1
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• pp.26-37
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• 2022

Purpose: Japan established the convalescent rehabilitation wards, corresponding to Korea's rehabilitation medical institutions, in 2000 and developed it into the present system through continuous revisions. This study sought to analyze the issues and tasks faced by Japan segregated by the period of revision of convalescent rehabilitation ward-related medical fee regulations, through a literature review and further aimed to explore the direction of development of domestic rehabilitation medical institutions. Methods: Ten revisions of the medical fee regulations were classified into three stages based on quality evaluation: (1) the quantitative expansion stage (2000-2006); (2) quality evaluation introduction stage (2008-2014); and (3) quality evaluation maturity stage (2016-2020). Results: The following issues and tasks emerged: (1) For the quantitative expansion stage; insufficient rehabilitation within the ward, insufficient after-hour rehabilitation, insufficient connection with acute-stage hospitals and maintenance facilities, and the low ratio of specialists. (2) For the quality evaluation introduction stage; disparity in the manpower between institutions, the necessity of a 365-day rehabilitation system, avoidance of critical patients, and the problem that an increase in the amount of rehabilitation did not lead to a qualitative improvement. 3) For the quality evaluation maturity stage; cream-skimming issues in selecting patients, inappropriate evaluation of rehabilitation effects, and the necessity of follow-up measures after discharge. Conclusion: It is worth referring to the established regulations in Japan, and concurrently it is necessary to strengthen the evaluation of the structures, processes, and results when operating and evaluating rehabilitation medical institutions in Korea taking into account the side effects that could be identified in Japan.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.9
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• pp.391-401
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• 2018

This study was conducted to investigate the effects of implementation of the healthcare accreditation system on patient safety, quality of medical care, organization culture and management performance of convalescent hospitals. Ten hospitals were selected at random from among 36 convalescent hospitals in Daegu that had obtained accreditation until September 2015. To accomplish this, hospital staff were surveyed from 15 February to 25 March, 2016 using a questionnaire with 253 objects. We investigated how the healthcare accreditation system has influenced patient safety, service quality, organization culture and performance of hospital management. The change in the treatment support system showed the highest score of 3.93 among quality change and medical service items, while that of personnel source culture showed the highest score of 3.78 points among organization culture items, and that of internal process view, study and growth view showed the highest score of 3.71 among management performance items. Multiple regression analysis revealed that factors positively changing hospital management performance were nurses, employees and managers, basic value systems, organization culture, personnel source culture, open system culture, hierarchical culture, and production oriented culture. The quality of patient safety and medical care was positively influenced by changes in the quality of convalescent hospitals after implementation of the healthcare accreditation system. However, among the four types of organizational culture, the financial perspective was relatively low compared to other perspectives.

• The Korean Nurse
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• v.22 no.3 s.121
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• pp.42-48
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• 1983