• 보건교육건강증진학회지
• /
• 제27권2호
• /
• pp.37-48
• /
• 2010

Objectives: In health care setting, patient education and health promotion services are inexpensive and effective initiatives to change health behavior due to use medical service resources and personnel. This study performed to define the responsibilities and competencies of health education specialist in private health care setting. For our suggestion, we reviewed regulatory, recommendation, and programs related to health education and promotion in clinics and hospitals. Results and Conclusion: The health promoting hospital and health services in Europe and innovative hospitals of community health promotion in the U.S. were examples of approaches that supply target groups with health promotion services in health care setting. The National Commission for Health Education Credentialing has suggested the specified responsibilities and competencies of health education specialist in health care setting according to their general duty. Considering the recommendation of the NCHEC, our suggestion included: 1) the three kinds of job scope, 2) the major targets, 3) the specified responsibilities and competencies, and 4) the available health promotion programs in clinic and hospital setting. The suggestion will contribute to the development of job market for health education specialist and to the cooperation with community health resources in health promotion services and comprehensive health care.

• 보건행정학회지
• /
• 제20권2호
• /
• pp.53-68
• /
• 2010

In health care, the process of resource allocation becomes a controversial process of rationing, as scarce resources are allocated between the numerous health care interventions. Especially for the last few years, decisions to define and expand the benefit package of National Health Insurance have always become the object of fierce criticism. It is partly because we have not reached a collective agreement as to what the most important criteria for spending priorities are. This paper considers the procedures and the principles which could be used to determine rationing in health care, and emphasizes the need to have explicit principles which determine patient access to care and to have an evidence base to inform rationing decisions. Also, the need to set up a public committee is suggested to take rationing decisions on behalf of government and NHS and to present them as evidence-based decisions.

• 보건행정학회지
• /
• 제17권3호
• /
• pp.106-128
• /
• 2007

The Korean health care system is under great controversy. Over the last 30 years, main goal of health policies was to pursue equal access of health care services. However, another goal of health policies laid on efficiency and Quality of care, it had lower priorities. Superficially, controversy stems from priority setting among goals of health care system, equity, efficiency and quality. At a deeper level, arguments arise from disagreement and confusion about the values of Korean health care system. One of the value spectrums believes that health care is the basic right of human beings, therefore it should be produced and distributed on need approach, and needs are known to be decided by professionals. If we accept need approach, health care is a pubic good. Another value of spectrums considers that health care should be distributed on demand approach. Demand approach means that health care is a consumption good on the positive economics, while normative judgement believes that health care is a public good. In equity aspect, health care is considered as a public good. Over the last several years, some of scholars proposed health care reform based on the principle of competition which is based on demand approach. Others argue that the competition principle based on demand approach is not appropriate for the reform proposal, because health care has to be approached on need base. If we do not make explicit values we should adopt, consensus building for reform is nearly impossible. From this perspective, this article will review an ideology and reality in health policies in Korea.

• Architectural research
• /
• 제9권1호
• /
• pp.9-18
• /
• 2007

The objective of this research study was twofold; 1) to explore and identify health supportive design factors in Swedish elderly care homes and 2) to understand their usefulness and suggest implication in Korean elderly care settings. A descriptive and explorative method was applied using a combination of field studies and semi-structured interviews. Three study trips were carried out during Sept. $14^{th}$ and Oct. $12^{th}$ 2005; two facilities situated in Stockholm suburbs and one in the south of Sweden. According to this research, the valuable factors to support health and well-being for the elderly are as follows; 1) Community integration: These elderly care homes are generally places close to a residential area center or a city center. Services are often shared between residents and community members at large, consequently there is a flow of "visitors" of all ages connecting with the facility on a daily basis. 2) Homelike environment: A noteworthy aspect of Swedish elderly care homes is keeping the facility appearance as homelike as possible. The associations with home may be explored through the appearance and configuration of both the exterior and interior of the building. These homes seemed to be designed with a conscious aim to create a homelike setting. 3) Small scale approach: Clustering of resident rooms is one method through which the small scale approach can be achieved in larger facilities. With unit clusters, the facility can foster opportunities for social interactions among resident. 4) Accessibility to garden and nature: The courtyard is a well developed concept in planning elderly care homes in Sweden. They are generally safe and easily accessible to the residents. Studying Swedish models may provide practical knowledge of how the physical setting may improve resident's health in Korean elderly care homes.

• 간호행정학회지
• /
• 제4권2호
• /
• pp.351-361
• /
• 1998

The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

• 한국사회복지학
• /
• 제59권2호
• /
• pp.223-249
• /
• 2007

학제간 팀 접근을 통해 사회복지서비스를 제공하는 의료현장에서는 의료팀의 사회복지사 역할에 대한 명확한 인식과 기대를 파악하는 것이 사회복지사의 효과적인 역할수행에 매우 중요하다. 이에 본 연구는 의사, 간호사, 영양사 등의 의료팀성원을 대상으로 의료사회복지사의 역할에 대한 인식유형과 각 유형의 특성을 Q방법론을 활용하여 조사하였다. 연구결과 의료사회복지사에 대한 인식은 심리사회적 상담자 유형, 자원개발 및 연결자 유형, 복합기능수행자 유형의 3가지 유형으로 도출되었다. 이상의 결과를 바탕으로 의료사회복지실천의 함의를 찾아보았다.

• 보건행정학회지
• /
• 제27권2호
• /
• pp.114-120
• /
• 2017

The hospital standardized mortality ratio (HSMR) is a widely used generic measure for assessing quality of hospital care in many countries. However, the validity of HSMR as a quality indicator is still controversial. We critically reviewed characteristics of HSMR and suggested how to use HSMR as a quality indicator in the Korean setting. The association between HSMR and other quality measures of hospital care is inconclusive. In addition current HSMR model has shortcomings in risk adjustment because of the lack of clinical data, accuracy of disease coding, coding variation among hospitals, end-of-life care issues, and so on. Therefore, HSMR should be used as an indicator for improvement, not for judgement such as public reporting and pay-for-performance. More efforts will be needed to tackle practical and methodological weaknesses of HSMR in the Korean setting.

• 대한간호
• /
• 제35권4호
• /
• pp.51-56
• /
• 1996

This research was an attempt to restructure the curriculum of pediatric clinical education on the base of the analysis of the pediatric clnical experience of nursing students acquired according to the traditional hospital-based pediatric clinical education and the evaluation of its results. As the focus of health care changes, pediatric clinical education the future necessitates changes in the traditional clinical experince at all levels. The traditional concentration of clinical experience within an acute care setting must be restructured to include the expanding future roles of the nurse and the changes in the health care structure. In order to meet the need for restructuring, it is inevitably necessary to adopt an organizational design for pediatric clinical experience that is not all traditional. The additional experiences and variety of settings will enhance the quality of pediatric clinical experience. And as a matter of course this organizational change will enhance the student learning experience by giving them the opportunity to observe normal growth and development, preventive health care measures, and the role of the nurse outside the acute care setting. As the nursing's focus changes to meet the challenges of the future the faculty must apply themselves to these changes to prepare students for the future. Students must be ready to fill the many roles that nurses will hold in the future.

• 보건행정학회지
• /
• 제30권2호
• /
• pp.164-177
• /
• 2020

This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.

• 간호행정학회지
• /
• 제13권3호
• /
• pp.352-361
• /
• 2007

Purpose: The purpose of this study was to develop roles and organizational policy of advanced practice nurses (APNs) in an acute hospital setting. Method: The design of the study was to descriptive-exploratory. Sample consisted of 43 participants who included 13 nurses, 18 nurse managers and 12 physicians. Survey, interview and focus group interview were performed to obtain the data. Results: The expected roles of APNs were education and counseling, direct management patient care with advanced skills, research, and collaboration and coordination among several departments. The expected outcomes were patient satisfaction, improved access to care, decreased the rate of complications, and speedy provision of services. Based on research, a proposal of APNs roles and organizational policy in a hospital setting was developed, which included definition of APNs, qualification, roles and specific roles, specialty areas, accountability, recruitment and affiliation, privileges, and expected outcomes. Conclusion: This study gives a guideline on how to introduce and use APNs in acute care tertiary settings.