The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.
Subramanian, Ganesh Chidambar;Arip, Masita;Subramaniam, T.S. Saraswathy
Safety and Health at Work
/
v.8
no.3
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pp.246-249
/
2017
Health-care workers are at risk of exposure to occupational infections with subsequent risk of contracting diseases, disability, and even death. A systematic collection of occupational disease data is useful for monitoring current trends in work situations and disease exposures; however, these data are usually limited due to under-reporting. The objective of this study was to review literature related to knowledge, risk perceptions, and practices regarding occupational exposures to infectious diseases in Malaysian health-care settings, in particular regarding blood-borne infections, universal precautions, use of personal protective equipment, and clinical waste management. The data are useful for determining improvements in knowledge and risk perceptions among health-care workers with developments of health policies and essential interventions for prevention and control of occupational diseases.
This research seeks opinions and development plan in forceful measures of qualifying examinations analyzing awareness of people in charge of medical tour about the qualifying examination system of international medical tour coordinator. The result of research shows the relatively positive awareness towards the qualifying examination and its system of international medical tour coordinator. Regarding the examination subjects, score about the necessity of subject where medical professionalism is considered marked high(4.01). About whether they would take the test or not, there was careful difference in the awareness of examination system(0.019) and operation method(0.004.). For the qualifying examination to be settled and thus to reinforce the professionalism, it is considered essential to have improvement in the problems of treatment towards acquisitors of certificate and awareness of field regarding the certificate, and review of supplementary subject aimed at the reinforcement of medical professionalism in terms of examination subjects.
Journal of Korean Academy of Nursing Administration
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v.5
no.1
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pp.113-136
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1999
There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.
Background: Our study objectives were to evaluate the medical economics of cervical cancer prevention and thereby contribute to cancer care policy decisions in Japan. Methods: Model creation: we created presence-absence models for prevention by designating human papillomavirus (HPV) vaccination for primary prevention of cervical cancer. Cost classification and cost estimates: we divided the costs of cancer care into seven categories (prevention, mass-screening, curative treatment, palliative care, indirect, non-medical, and psychosocial cost) and estimated costs for each model. Cost-benefit analyses: we performed cost-benefit analyses for Japan as a whole. Results: HPV vaccination was estimated to cost $291.5 million, cervical cancer screening $76.0 million and curative treatment $12.0 million. The loss due to death was $251.0 million and the net benefit was -$128.5 million (negative). Conclusion: Cervical cancer prevention was not found to be cost-effective in Japan. While few cost-benefit analyses have been reported in the field of cancer care, these would be essential for Japanese policy determination.
The Journal of Korean Academic Society of Nursing Education
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v.15
no.1
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pp.53-61
/
2009
Purpose: This study was conducted to evaluate the need for education for emergency care in nursing homes. Method: 312 people who were engaged in caring for the elderly at nursing homes in D-metropolitan c! ity answered the questionnaires about the experiences, the need, and the ideal methods of education for basic emergency care, from Jul. 1. 2007 to Jul. 30. 2007. Result: 69.9% were female. Only 7.1% were nurses and the rest did not have majors in the medical field. 83.0% had experienced education for emergency care, and 89.2%, 78.4% and 44.8% of them had been educated about cardiopulmonary resuscitation, airway obstruction care, and fracture/sprain/dislocation care respectively. Fifty-three who had not experienced education answered 'no opportunity' as a cause of non-education. The need for emergency care education was 4.53/5.00, and the desire to receive education was 2.81/3.00. Mainly workers wanted to be educated abo! ut airway obstruction (88.1%), and breathing assistance & cardiac massage (72.4%). Workers preferred to be educated 1-2 times per year for 2-3 subjects, through programs including both lecture and practice. Conclusion: It is essential to create an adequate program and apply it to the people engaged in caring for the elderly.
Hospice and palliative care (HPC) education is an essential component of undergraduate medical education. Since February 4th, 2018, withholding and withdrawing life-sustaining treatment at the end of life (EOL) has been permitted in Korea as put forth by law, the "Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life." Therefore, Korean medical schools have faced a challenge in providing comprehensive HPC education in order to better prepare medical students to be competent physicians in fulfilling their role in caring for patients at the EOL. There have been considerable variations in the evolution and organization of HPC education across Korean medical schools for the past 20 years. In 2016, all medical schools taught HPC curriculum as a separate course or integrated courses, with the most frequently taught topics including: delivering bad news, pain management, and the concept of palliative medicine. However, the content, time allocation, learning format, and clinical skills practice training of HPC education have been insufficient, inconsistent, and diverse. For this reason, we propose a HPC curriculum containing seven domains with 60 learning objectives in a course duration of over 20 hours based on the Palliative Education Assessment Tool (PEAT) as standard HPC curriculum. Furthermore, we recommend development of a national curriculum for HPC/EOL care education to be organized by the HPC board and managed under the accreditation criteria of the Korea Institute of Medical Education and Evaluation.
Neuroprotection or prevention of neuronal loss is a complicated molecular process that is mediated by various cellular pathways. Use of different pharmacological agents as neuroprotectants has been reported especially in the last decades. These neuroprotective agents act through inhibition of inflammatory processes and apoptosis, attenuation of oxidative stress and reduction of free radicals. Control of this injurious molecular process is essential to the reduction of neuronal injuries and is associated with improved functional outcomes and recovery of the patients admitted to the intensive care unit. This study reviews neuroprotective agents and their mechanisms of action against central nervous system damages.
During the Joseon Dynasty, Jeju had a unique aspect that differentiated it from other regions in terms of their medical system, such as the exclusive deployment of shimyak dispatched to Gamyeong and Barracks units due to the uniqueness of being an island. This study uses various historical sources to verify that these differences existed throughout the medical system and procedures of Jeju in the late Joseon Dynasty. The following significant conclusions were drawn: 1) Looking at the work and characters of Jejushimyak reveals the inherent limitations of Jeju medical care in the Joseon Dynasty. Compared to other regions' shimyak, Jejushimyak had two limitations: it was difficult to engage in only medicine and the quality of medical doctors declined due to the avoidance of major medical doctors' households. 2) The establishment of public health care in Jeju through Medical Cadets failed. Jeju medical science obviously played an essential role in public health care in the early 18th century. However, there was no continuity in the garden, etc. Hyangri, who was in charge of Medical Cadets, was in charge of various fragrances as needed. Thus expertise in medicine was lacking. 3) The cultivated herbs of Jeju's herb field show the failure to supply herbs for institutional medicine. It was impossible to supply enough herbs to implement institutional medicine in Jeju. In that case, it would have been necessary to discover alternative local herbs or to bring them in from outside, but there was barely any such effort. In conclusion, in the late Joseon Dynasty, Jeju failed to establish a foundation for centrally administered institutional medicine. There was a lack of all the entities that provided medical care and herbs that could be used for medical care. The reason that Jeju continued to follow traditional shaman medicine in the late Joseon Dynasty was because there was no other alternative.
Purpose: We evaluated the status of patients enrolled in South Korea's pediatric palliative care pilot project based on the experience of a single center. This study examined factors related to end-of-life services and differences in medical costs. Methods: The medical records of 120 patients referred by a pediatric palliative care team were analyzed retrospectively. Data from July 1 to February 28, 2022 were collected and analyzed using the chi-square test and the Mann-Whitney U test. Results: Volunteer programs and psychological support (100%), family support and education (99.2%), and financial support through institutional linkage (62.5%) were provided to the participants. In the deceased group, there were no significant differences in general characteristics, which included age, gender, primary disease, religion, duration of hospitalization in an intensive care unit (ICU) and non-intensive care unit (non-ICU). However, the ICU group had fewer opportunities to access individual pain and physical symptom management than the non-ICU group and there were limitations in linking with external resources. Medical expenses were significantly different for the ICU group, with a 3-times higher average cost than the non-ICU group. Conclusion: Although an individualized approach is needed for each patient in pediatric palliative care, psychosocial care is essential. In addition, if early intervention for end-of-life pediatric patients is available from a palliative care team, the cost burden of medical care for patients and their families should be minimal.
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