• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권4호
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• pp.51-60
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• 2021

Purpose: Tuberculosis(TB) care unit in public health center should be carefully considered to be re-designed as an infection safety environment for both patient and healthcare workers. So, for the enhancement, this study analyses the facility requirements for co-using the screening clinic as a TB and other respiratory disease care unit. Methods: Not only screening clinic facility guidelines from "A Study for Standard Triage Design and Construction Document" but also the guidelines of TB care and related medical facility are reviewed; KDCA, CDC, ECDC and WHO as a TB care, and FGI and NHS for facility. The facility requirements are summarized space, approach, and mechanical requirement in order. By comparing the summary and screening clinic facility guidelines, supplementations are proposed for TB care unit setting. Results: The result of this study shows that both the space program and mechanical requirement of the screening clinic and that of TB care unit are almost identical and could be share, which include direct airflow or negative air pressure in an exam room. To increase functional and economical efficiency, however, it is necessary to consider a multi-functional negative pressured room, So care process may be re-designed based on a room type; face-to-face room or glass wall inbetween. Implications: The facility guidelines for TB care unit of a public health center should be developed to build a safe environment for infection control by reflecting its medical plan and budget.

• 보건행정학회지
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• 제21권1호
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• pp.115-131
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• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• 동서간호학연구지
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• 제5권1호
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• pp.114-119
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• 2000

This paper reviews the curriculums on the nursing in oriental medicine currently provided by Korean nursing education institutes. As of October 2000, 14 of 48 four-year-system and 40 of 65 three-years system nursing schools provide the various academic courses and programs titled with the nursing care in oriental medicine. Depending on schools, the credit assigned to these courses and programs vary widely ranged from 1 to 8 units. Even in some schools the courses are offered not as a regular credit course but as a part of other courses on time sharing base. It is absolutely insufficient efforts in promoting education on the nursing in oriental medicine. The oriental medicine is basically based on the principles that the most critical factor in promoting health and preventing disease is the process for improving the condition of both physical and mental part of patients. In this context it seems to be an valuable attempt to apply the principles of oriental medicine to the field of nursing care, and to develop the new methods. It is because promoting health, preventing disease, recovering health, alleviating pains are the basic responsibilities of nursing care. The national health policies have been increasingly emphasizing low-cost and high-efficiency just as in economic policies. In terms of cost-effectiveness nursing education in oriental medicine seems to be evaluated as good enough to satisfy these efficiency requirements. As a initial step for promoting and specializing the nursing education in oriental medicine it is absolutely needed to introduce and expand the curriculum on this new field. Increasing concerns about the oriental medicine as the third medical care is the world wide phenomenon now. Considering this trend, current insufficient curriculum on nursing in oriental medicine in education institutes, especially in four-year system nursing school, might be an undesirable phenomenon for future development of nursing education in Korea. In-depth studies about this issue are seriously needed.

• 대한간호학회지
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• 제31권2호
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• pp.279-291
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• 2001

Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.

• 가정∙방문간호학회지
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• 제30권1호
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• pp.69-83
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• 2023

Purpose: This study aimed to present Blue Ocean strategies by deriving the strategic elements of a visiting nursing center and conducting a survey on the importance and satisfaction of care clients. Methods: First, a FGI was conducted targeting the head of the visiting nursing center to derive its strategic elements. Subsequently, importance and satisfaction surveys on the derived strategy elements were analyzed, an IPA matrix was derived, and an as-is ERRC Blue Ocean strategy was established. Kano's Three-Factor Theory was used to derive a competitive position matrix and establish a to-be ERRC Blue Ocean strategy. The Blue Ocean Strategy for Visiting Nursing Center Management is presented in this study. Results: Four as raise factors were derived from combining the results of the as-is, to-be ERRC strategy element analysis: retention of competent nurses, education in medication management, maintenance of high customer satisfaction, and prompt handling of customer complaints. Additionally, the customer's health condition evaluation was derived. Conclusion: Blue Ocean Strategies can be used to analyze, derive, and establish management strategies in various nursing-related entrepreneurship fields.

• KDI Journal of Economic Policy
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• 제12권3호
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• pp.47-69
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• 1990

한국(韓國)의 의료보험제도(醫療保險制度)는 일본제도(日本制度)를 거울삼아 서둘러 적용대상자(適用對象者)를 확대하여 1989년 전국민의료보험(全國民醫療保險)을 달성하였으나 제도(制度)와 효율적(效率的) 운영(運營)을 위한 장치가 결여되어 있고 직장(職場), 공교(公敎), 지역의보간(地域醫保間)에 형평문제(衡平問題) 제기되는 등 구조적인 과제를 안고 있다. 앞으로 제도(制度)의 개혁추진(改革推進) 노력으로 이 분야의 정책수립(政策樹立)과 집행(執行) 에 있어서 경직성을 줄이고 비용효과적(費用效果的)인 의료이용(醫療利用)을 도모해 나가지 못할 경우 낭비요인(浪費要因)이 점점 더 크게 불어나 국민의료비(國民醫療費)가 계속적으로 급속히 증대될 전망이다. 이와 같은 제도(制度)의 질적개선(質的改善)의 필요성에 비추어 최근 네덜란드가 시도하고 있는 제도개혁(制度改革)은 우리에게 여러가지 귀중한 교훈을 던져주고 있다고 판단된다. 네덜란드의 개혁안은 시장경쟁원리(市場競爭原理)를 폭넓게 수용하여 제도(制度)의 능률(能率)을 높이고 의료비(醫療費)를 절감하려는 취지를 담고 있다. 특히 의보가입자(醫保加入者)가 보험자(保險者)를 선택할 수 있고 또한 보험자(保險者)가 의료기관(醫療機關)을 선택할 수 있도록 관계(關係) 집단간(集團間) 상호경쟁(相互競爭)을 유도함으로써 효율(效率)을 증진시켜 나가겠다는 정책방향이 뚜렷히 제시되고 있어 우리의 주목을 끌고 있다.

• 디지털융복합연구
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• 제15권4호
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• pp.191-198
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• 2017

PHR(Personal Health Record)기반 헬스케어 서비스 플랫폼 지능화를 위해서는 사용자 맞춤형 건강정보 제공서비스가 필요하다. 본 논문에서는 개인 맞춤형 건강정보 추천을 위해서 온톨로지 기반 건강 정보 모델을 제안하였다. 또한 기계학습과 데이터마이닝 기법을 적용한 유사 건강정보 탐사 알고리즘을 설계하였다. 기존의 데이터마이닝 기법중 연관규칙 알고리즘을 확장하여 속성을 기반으로 연관규칙 탐사를 수행하여 지식탐사의 연관성을 높이고 효율적인 탐사시간을 제공할 수 있도록 하였다. 머신러닝의 한 기법인 K근접이웃 알고리즘을 적용하여 사용자 프로파일별 그룹화를 수행하고 유사패턴의 사용자 프로파일을 검색할 수 있도록 하였다. 이는 사용자의 질환과 건강상태에 따른 맞춤형 건강정보 탐사 수행의 효율성을 높인다. 제안된 알고리즘은 개인 맞춤형 헬스케어 서비스 플랫폼에서 추론과정에 적용되어 사용자에게 개인맞춤형건강정보를 추천하는 것을 가능하게 한다. 이는 고령화사회에서 스마트한 자가 건강관리에 활용될 수 있다.

• 대한예방한의학회지
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• 제6권1호
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• pp.1-14
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• 2002

The proportion and role of public sector in health care industry is very small in Korea. Asymmetric distribution of health care resources is one of the major health care concerns. This issue is so important that it raises a question of accessibility, availability, continuity of care and equity of rural area people's health care utilization. To solve these problems and to satisfy the basic demand of oriental medical service in rural areas, the oriental public health doctors were placed in rural health centers since 1998. The main objectives of this study are twofold: to measure the cognition and attitude of health center directors on the strategies for utilizing oriental public health doctors and to provide basic data for improving the health manpower management program. Data have been collected by way of the self-administrative questionnaires. Developing the questionnaire, the literature review on the previous studies and delphi method were carried out. The response rate was 38.7%. The results of this study are summarized as follows; 1. community people respond positively on the oriental medical service activity in health center. 2. In regard to workloads of oriental public health doctor, 'appropriate' was 81.1% and 'burdensome' was 18.2%, respectively. 3. The 94.0% of respondents thought that the oriental medical service will be continued. 4. To activate oriental medical service in health center, the sufficient budget and provision of aid workers is a necessity. 5. The 75.5% of health center directors respond positively on the allocation of oriental public health doctor to health sub-centers. 6. Health center directors agreed that oriental public health doctor should perform the clinical service as well as prevention and health promotion activity. These results recommend that oriental medical service in health center should be continued gradually, and oriental public health doctors working at health center perform their work efficiently. Undoubtedly, their activity should be more focused on health promotion and disease prevention than daily patient care. For achieving this objective, more support of governmental policy is essential for utilizing oriental public health doctor and better health of the rural area community people.

• 한국생명과학회:학술대회논문집
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• 한국생명과학회 2006년도 제47회 학술심포지움 및 추계국제학술대회
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• pp.94.2-94.2
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• 2006

• 대한장애인치과학회지
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• 제13권2호
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• pp.73-79
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• 2017

The purpose of this study was to analyze the dental treatment of patients with disabilities, especially according to the frequency of general anesthesia, and to propose the improvements in oral care. The subjects of the present study were 85 patients including age, sex, medical condition, dental treatment and the number of general anesthesia. The patients were divided into regular and irregular check groups according to their follow-up patterns. These two groups were compared for the frequency of general anesthesia and the type of repeated treatment. The results showed that restorative treatment was superior in numbers under first visit of general anesthesia. And more general anesthesia was performed in the irregular recall check group compared with the regular recall check group. This survey suggest that easy access to a dental clinic and the convenience of treatment is needed. On the other hand, there is a time limit on the dental care for disabilities by the dentist. Therefore oral care training program should be simultaneously provided for parents to improve the efficiency of dental care at home. In conclusion, efforts should be made for more comprehensive and effective dental care including regular recall check and preventive home care for disabilities.