• Perspectives in Nursing Science
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• 제15권2호
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• pp.81-91
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• 2018

Purpose: This study aimed to suggest strategies for advancing local-government-based accreditation systems and surveyor training in long-term care facilities in Korea. Methods: A comprehensive review of the literature including research papers and official reports issued by governments from the United States, Australia, and Japan was conducted to explore domestic and international policies related to long-term care facility certification and accreditation systems. Results: The USA has two types of care quality assurance systems including mandatory certification (5-star rating system) by the Centers for Medicare and Medicaid Services and voluntary accreditation by the Joint Commission on Accreditation of Healthcare Organizations. Australia operates a government-based mandatory accreditation system for all long-term care facilities through the Australian Aged Care Quality Agency. Japan, particularly the Tokyo district, operates a third-party evaluation system that involves the voluntary participation of long-term care facilities. Conclusion: This study provides several strategies to enhance accreditation processes and surveyors'expertise. For instance, motivating facilities to voluntarily participate in accreditation is necessary by 1) providing sufficient and continuous consultations and feedback about how to improve care quality, 2) differentiating accreditation domains and indicators from the national health insurance certification system, and 3) actively utilizing accreditation results and providing incentives.

• 한국인구학
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• 제8권1호
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• pp.118-138
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• 1985

This paper is aimed to analyse the recent changes in family planning as a step in an evaluation of the results of the population control policy which has been strenuously pursued by the government since December 1981. The data used in this analysis comes from the 1985 national fertility and family planning survey conducted by the Korea Institute for Population and Health (KIPH) in May 1985. According to the 1985 survey data, there have been great changes in both the contraceptive practice and fertility rates since the strengthening of the government's population control policy in 1 981. The contraceptive practice rate for married women aged 15-44 has increased from 57.7% in 1982 to 70.3% in 1985, an increase of 12.6% points in the short span of only 3 years. During the same period, the total fertility rate has declined from 2.7 in 1982 to the population replacement level which was planned to achieve by 1 988. More than 80% of women aged over 30 or with two children or more are practicing contraception, while the practice rates of women with 0-1 children are 14.0% and 45.1% respectively. The survey has revealed that the increase of contraceptive practice rate during 1982-1985 has mainly attributed to the high acceptance of sterilization procedures which practice rate of the married women has increased from 28.1% to 40.3% for the period. Also, the survey data shows that 24.7% of those women with only one child is practicing contraception for thepurpose of fertility termination. The government, taking into account of rapid changes in contraceptive practice and fertility rates, is formulating a population plan during the sixth fiveyear economic and social development plan (1987-1991) to achieve 1% ofpopulation growth rate by 1993, which was planned to realize by 2000. In order to meet this demographic goal, the existing population control policy measures should be improved to be suited to the recent contraceptive use and fertility changes. From this standpoint, the following considerations should be put forth; 1) improvement of the current program management systems including target allocation and evaluation schems for recruiting new acceptors in the young 20s groups to use contraceptives for birth spacing and to increase high continuation rates through the strengthening of follow-up services for the acceptors, 2) increase of self-supporting contraceptive users by promoting commercial advertisements on contraceptives through mass media including T.V. and radio, 3) development of social support policies including incentive schems, and strengthening of IE & C activities for increasing the proportion of the one-child family, 4) strengthening of population and family planning education in and out school youth, and 5) strengthening of management capabilities at the provincial and local program managers.

• 한국농촌건축학회논문집
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• 제15권4호
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• pp.95-102
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• 2013

Recently (2010), South Korea's aging rate is 11%. and expected to be 32.3% in 2040, and Japan's aging rate in 2010 is 23%, and in 2040 is expected to be 34.5%. As aging progresses, it is increasing with the elderly person with dementia. However, elderly welfare facilities are insufficient. To take care stability of elderly people with mental and physical disabilities, we need to prepare a lot of welfare facilities for the elderly. Whenever physical conditions and service needs change of the disability elderly, Elderly are forced to move to the other facility. They move from familiar places, beloved local base to unfamiliar places. They are under a lot of stress in order to adapt to new environment. This research is to check out the possibility of the systems and the effectiveness of various services and the flexibility of management in Japan. Takurosyo is responsible for a variety function of elderly medical welfare facilities. Within a short time, our country, has entered into a super-aged society, elderly health and welfare facilities are needed. However, because it requires enormous financial, it is difficult to build a new building in reality, However, if remodeling existing buildings, We can build many low-cost small-scale multi-functional welfare facilities such as the takurosyo. Such that facility would be available to us.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2059-2065
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• 2013

This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.

• 한국노년학
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• 제28권4호
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• pp.1227-1248
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• 2008

본 연구는 노인의 죽음준비도를 독립변수로, 노인의 우울 및 죽음불안을 매개변수로, 노인의 성공적 노화로서 자아통합감을 종속변수로 설정하고, 청주시에 거주하는 만 60세 이상의 노인들을 대상으로 설문조사하여 조사대상자들의 일반적 특성에 따른 연구변수들의 차이를 검증하고 이들 변수간의 영향관계를 분석해 봄으로써 성공적인 노후생활을 영위할 수 있도록 죽음준비 및 건강한 노후생활 교육 프로그램 개발을 위한 기초 자료를 마련하는 데 그 목적을 두고 있다. 분석결과 연구문제에 따라 첫째, 학력, 건강상태, 경제수준, 외부활동량에 따라서는 연구변수들의 차이가 유의미한 것으로 나타났다. 둘째, 노인의 정신적 죽음준비도는 성공적 노화로서의 자아통합감에 긍정적 영향을 미치는 것으로 나타났다. 한편 노인의 의례적 죽음준비도는 성공적 노화로서 자아통합감에 영향을 미치지 않는 것으로 나타났다. 셋째, 노인의 정신적 죽음준비도가 성공적 노화로서의 자아통합감에 미치는 영향을 노인의 우울 및 죽음불안이 부분 매개하는 것으로 나타났다.

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.115-123
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• 2002

1997년 1월 1일부터 2001년 12월 31일까지 5년간 울릉군 보건의료원 응급실을 내원하여 헬리콥터를 이용하여 육지병원으로 후송된 환자를 조사하였다. 헬리콥터가 운행된 회수는 5년간 88회, 후송된 환자들은 110명으로 113건이었다. 헬리콥터의 연도별 운행 회수는 1997년은 13회(14.8%), 1998년에는 17회(19.3%), 1999년에는 18회(20.5%), 2000년에는 17회(19.3%), 2001년에는 23회(26.1%) 운행하여 연도에 따라 헬리콥터 운행 회수가 증가하는 경향을 보였다. 헬리콥터 종류는 해양경찰 헬리콥터가 46회(52.3%), 119 소방 헬리콥터가 19회(21.6%), 해군 헬리콥터는 14회(15.9%), 민간 헬리콥터가 7회(8.0%) 운행하였다. 후송 시간대는 오전 6시부터 오후 6시 이전까지 79회(89.8%)가 후송되었다. 후송 환자의 계절별 분포는 가을에 25회(28.5%), 봄에 23회(26.2%) 운행하였다. 최종 후송 지역은 경상북도 포항시 47건(43.1%), 강원도 강릉시 34건(31.2%), 대구광역시 16건(14.7%) 서울 10건(8.8%) 등의 순이었다. 후송 환자의 성별 분포는 남자가 71건(65.1%), 여자가 38건(34.9%)으로 남자가 많았다. 연령별 분포는 60세 이상이 31건(28.4%), 30대가 20건(18.3%), 40대가 16건(14.7%) 등의 순이었다. 진료과별 분포는 신경외과 42건(37.1%), 내과 21건(18.6%), 일반외과와 정형외과가 각각 13건(11.5%) 등의 순이었다. 질병별 분포는 뇌졸중이 27건(23.9%)으로 가장 많았으며, 골절이 13건(11.5%), 두부손상 11건(9.7%), 임신과 관련된 출혈 및 통증 10건(8.8%), 복막염 8건(7.1%) 등의 순이었다. 한국표준질병사인분류(3-KSCD)에 의한 분포는 순환기계의 질환(IX)이34건(30.1%), 손상, 중독및기타(XIX)가34건(30.1%), 소화기계질환(XI)이 23건(20.4%) 등의순이었다. 울릉도를 비롯한 도서지역의 응급환자 후송에는 헬리콥터의 이용이 필수적이다. 보다 효율적인 응급환자 후송을 위해서는 헬리콥터의 야간 운행, 헬리콥터 내의 환자감시장치 등의 의료장비의 확보, 공식적인 응급후송용 헬리콥터의 확보 및 이를 위한 법 제정 등이 이루어져야 할 것이다.

• 한국노년학
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• 제38권1호
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• pp.225-241
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• 2018

노인의 자가 운전은 노인의 활동범위를 확대시키고 사회참여의 기회를 제공한다는 점에서 노년기에 의미있는 활동을 위한 필요조건이다. 운전은 신체적, 인지적, 감각적 기능의 통합을 요구하며 인적, 심리적 요인의 영향을 받는 매우 복잡한 활동이기 때문에 노화로 인한 기능저하는 고령운전자의 운전수행능력에 영향을 준다. 본 연구는 체계적인 문헌고찰을 통해 고령운전자의 운전중단이나 사고위험 증가에 영향을 미치는 요소가 무엇인지 확인하는데 목적을 두고 있다. 문헌 검색을 위해 사용된 온라인 데이터베이스는 MEDLINE, Excerpta Medica database(EMBASE), Cochrane Library, KoreaMed, Pubmed 였으며, 사용된 MeSH용어는 'aged', 'aging', 'automobile driving', 'age factors'였다. 2007년 1월부터 2017년 9월까지 발표된 문헌을 검색하여 1,458건의 결과를 얻었으며 선정기준에 부합하는 18편의 연구를 추출하였다. 결과에서는 운전중단 요소 및 사용된 측정도구와 운전중단에 따른 인구학적 특성을 분석하였다. 운전중단 영역 중 신체적 영역에서 유의미한 결과를 나타내는 측정도구가 11개로 가장 높은 빈도를 보였으며, 운전중단과 관련된 요소에서는 정보처리속도, 수행기능, 운전능력, 운전습관이 각 4개씩으로 운전중단과 유의미한 결과를 나타냈다. 인구학적 특성에서는 성별과 연령에 따라 운전중단과 관련이 있었다. 본 연구결과는 노화로 인한 기능저하가 운전수행에 미치는 영향을 분석하여 운전중단 예측요소들을 파악하고 노인의 안전한 운전수행을 위한 대책 마련의 필요성을 강조한다. 또한 노인의 다양한 운전중단 예측요소를 바탕으로 개별적인 교육프로그램 등의 서비스를 체계적으로 구축할 필요성을 제시한다.

• 한국콘텐츠학회논문지
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• 제20권8호
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• pp.583-597
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• 2020

본 연구는 고령층의 사회복지서비스 이용과 사회복지정책 만족도에 주목하여 고령자의 사회복지 인식이 사회복지서비스와 사회복지정책만족도에 어떠한 영향을 미치는지 분석 하였다. 이러한 연구목적을 달성하기 위해 한국보건사회연구원과 서울대학교 사회복지연구소에서 조사하여 축적하고 있는 한국복지패널 자료를 근거로, 가구용, 가구원용, 복지인식 부가조사용을 결합한 머지데이터(merge data)를 활용하여 부가조사에 응답을 완료한 60세 이상 465명을 연구대상으로 자료를 수집하여 분석하였다. 본 연구결과는 다음과 같다. 첫째, "노인복지 인식(복지지출 인식, 복지대상 인식, 복지증세 인식)"은 "사회서비스 이용"에 부(-)의 영향을 미치는 것으로 나타났다. 둘째, "노인복지 인식(복지지출 인식, 복지대상 인식, 복지증세 인식)"은 "사회복지정책 만족도"에 부(-)의 영향을 미치는 것으로 나타났다. 셋째, "인구통계학적 특성(교육수준, 소득수준, 학력, 성별)"에 따라 노인복지인식이 사회서비스이용에 미치는 영향은 차이가 있는 것으로 나타났다. 넷째, "인구통계학적 특성(교육수준, 소득수준, 학력, 성별)"에 따라 노인복지인식이 사회복지정책 만족도에 미치는 영향은 차이가 있는 것으로 나타났다. 본 연구의 시사점은 다차원적인 복지인식과 사회서비스 이용경험을 사회복지정책 만족도의 영향요인으로 함께 살펴보았다는 점에 있다. 즉, 사회복지정책만족도의 영향요인으로 개인의 가치와 주관적 인식을 바탕으로 형성되는 복지인식에 주목하였으며, 고령자의 복지인식과 사회복지정책만족도의 관계에서 사회서비스 이용경험이 사회복지정책만족도에 도움이 되고 있는지 살펴봄으로써 복지정책과 복지현장의 실천적 대안을 모색하였다는데 의미가 있다.

• International Journal of Advanced Culture Technology
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• 제9권1호
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• pp.16-21
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• 2021

As the average age of national veterans has increased from 69 years old(2011) to 71 years old(since 2015) over the past five years, the overall medical service cost of veterans has increased by about 20%. The main cause of this phenomenon is 'ultra-aging', which accounts for 67% of veterans, while the proportion of health insurance patients aged 70 or older is 9%. Therefore, it is judged that the analysis of the trend of use of medical services at veterans hospitals in each region that is in charge of severe medical services of national veterans can serve as an opportunity to seek countermeasures for the severe medical system of national veterans. First of all, based on the details of major medical expenses (hospitalization, outpatient, pharmaceutical expenses) by region for the last 10 years(2010-2019), data significance was performed through a chi-square test, and the Central Veterans Hospital and Non-Central Veterans Hospital using EXCEL. 'Expected frequency' was calculated by year. By applying the CHITEST(observation frequency, expected frequency) function again, the p-value(p<0.05) was calculated, and the profit bias of each region's veterans hospital could be determined. The specific research method is for the last 10 years(2010-2019) for state-sponsored patients_outpatient treatment income, state-sponsored patients_hospitalization income, exempt patients_outpatients at the Central Veterans Hospital, Busan Veterans Hospital, Gwangju Veterans Hospital, Daegu Veterans Hospital, and Daejeon Veterans Hospital. A one-way analysis of variance was conducted to verify the significance of the difference between group averages on the status of 5 medical revenues of veterans hospitals in each of the 5 regions, including medical treatment income, reduced patients_hospitalization income, and reduced patients_medicine expenses. It was found to be significant(p<0.05) at all levels, including region and type. Finally, the bias in the profit structure of regional veterans hospitals was the highest in 2017(p=0.0004) and the lowest in 2013(p=0.0349). In addition, in the profit structure of the Veterans Hospital, the year in which the'regional' variable worked the most was 2019, and the year with the least affected was 2010. The order of the former is Jungang(=31,674,713), Busan(=12,314,614), Gwangju(=11,957,038), Daegu(=10,168,015), and Daejeon(=6,991,034), and the order of the latter is Jungang(=57,868,791), and Busan(=19,183,194). Gwangju(=17,904,712), Daegu(=15,656,034), and Daejeon(=14,377,395). In conclusion, the profit bias of veterans hospitals repeatedly raced the lowest(p=0.01986) and highest(p=0.03499) for the past five years(2010-2014) year by year, with the 'regional' variable being the most in the veterans hospital's profit structure It was identified as a major influence factor. On the other hand, for the last 5 years (2015-2019), the influence factors of the'regional' variable every year were in 2015(p=0.02015), 2016(p=0.01741), 2017(p=0.00045), and 2018(p=0.00394). in 2019(p=0.00227), a significant difference was confirmed at a very low level.

• 한국응급구조학회지
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• 제16권1호
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• pp.7-18
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• 2012

Purpose: The purpose of this study is to help care workers to do their best as first respondents by analysing their recognition, knowledge, and self-efficacy on basic CPR (cardiopulmonary resuscitation) that is directly connected to the lives of patients and thus their education and methods can be improved for their positive basic lifesaving work. Method: For this purpose 360 structured questionnaires were used to the subjects in the eastern area of Jeonnam province from June 20 to July 4, 2011. Of these questionnaires 217 were used excluding 113 incomplete, 27 error, and 3 male ones. The collected data were analysed by the real number, the percentage, the average, the standard deviation, t-test, ANOVA, and Tukey with SPSS WIN 18.0. Results: 1. In the view of subjects, those aged over 51 accounted for 96(44.2%) as the majority, high school graduates, 95(43.8%), worked for 1 or more than 1 year-less than 2 years, 66(30.4%), experienced to see persons collapsed losing their consciousness, 46(21.2%), took the education, 184(85.7%), had 1 session of education, 80(43%), got the last education for 2 or more than 2 years 68(37%), and practiced through mannequin for the education aids, 86(46.7%). 2. There was significant difference in the view of recognition with the length of work (p=.010) and experienced to see persons collapsed losing their consciousness (p=.020), in the view of knowledge with academic background (p=.040) and the length of work, and in the view of self-efficacy with academic background (p=.002), the length of work (p=.010) and experienced to see persons collapsed losing their consciousness (p=.000). 3. There was significant difference in the session of education (p=.000), last education (p=.025) and education aids for basic CPR. Self-efficacy had significant difference according to the session of education for basic CPR (p=.001) and the time of education (p=.000). 4. There was correlation between recognition and self-efficacy (r=.41). The higher the recognition is, the better the self-efficacy improves. However the correlation between knowledge and self-efficacy was so low that the former did not have influence on self-efficacy. Conclusions: It needs to offer education to the lifesaving workers based on their experiences. If there is education more than 2 sessions in a year with mannequin and the simulation providing sufficient hours, care workers' recognition would be increased resulting in higher self-efficacy and thus they could keep the role of active lifesaving worker at the first practical site.