• 보건의료생명과학 논문지
• /
• 제11권2호
• /
• pp.351-360
• /
• 2023

건강보험심사평가원 2018년 고령환자데이터셋(HIRA-APS)을 이용하여 요양병원 입원환자 33,821명을 주요 질병군별로 구분하여, 의료이용 현황과 특성을 파악하여, 요양병원의 기능정립에 효과적인 정책 기초자료를 제공하고자 하였다. 첫째, 질병군에 따라 의료이용 특성에 차이를 보이고 있어, 환자의 질병군 특성에 맞는 치매 전문, 재활 전문, 호스피스 전문, 회복기 전문 등 특화된 요양병원 설립과 운영이 필요하다. 둘째, 요양병원 입원환자의 연간 입원일수에 영향을 미치는 요인 중 주상병별로는 마비군, 뇌혈관질환군, 치매군이 가장 길었으며, 환자분류군별로는 인지장애군이 가장 길어, 질병군별 장기 환자에 대한 의료 수요 및 질 관리가 필요하다. 셋째, 요양병원 입원환자의 치료결과 중 정상 퇴원에 영향을 미치는 요인 중 질병군별로는 근골격계질환군에서 가장 높았고, 마비군, 뇌혈관질환 순으로 퇴원 후 재가 프로그램 지원이 요구된다.

• 보건행정학회지
• /
• 제15권4호
• /
• pp.26-45
• /
• 2005

The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

• 디지털융복합연구
• /
• 제17권4호
• /
• pp.167-176
• /
• 2019

본 연구는 간호사와 간호대학생을 대상으로 간호사의 이미지에 대한 유형을 파악하기 위해 수행되었으며 Q방법론이 이용되었다. H시에 임상경력이 1년 이상 된 현직 간호사 135명, H대학교 간호학과 전체 학년 250명이 제시한 총 385개의 진술문으로 구성된 Q 모집단에서 40개의 Q 표본을 추출하였다. Q 표본의 분류는 현직 간호사 10명과 간호대학생 40명이 수행하였으며 PQ method Program을 이용하여 자료 분석을 하였다. 연구결과 간호사 이미지에 대한 인식 유형은 '교과서형', '현실형', '과도기형'으로 도출되었다. 본 연구결과는 현직 간호사와 간호대학생이 융합한 간호사 이미지 유형의 차이를 분석한 것에 의의가 있다. 간호사 이미지의 향상을 위해서 체계적인 교육과정 개발 뿐 만 아니라 의료 현장을 반영한 적극적인 보건의료정책 방안 마련을 제언한다.

• 문화기술의 융합
• /
• 제8권3호
• /
• pp.105-112
• /
• 2022

본 연구는 보건 클러스터 교육과정에 참여한 고등학생들의 경험을 통해 클러스터 교육과정의 성과 및 과제를 분석한 질적연구이다. 연구결과 '경쟁적 환경에서 최선의 선택', '보건에 대한 인식의 변화', '다양한 보건세계에 대해 경험해 보고 싶은 욕구', '비정규 교과과정 운영의 한계', '기분 좋은 상상을 하게 됨'의 주제가 도출되었다. 본 연구를 통해 클러스터 교육과정에 참여한 학생들의 보건에 대한 인식이 긍정적으로 변화되고, 보건의료계열에 대한 정보습득을 통해 진로의 방향설정 및 진로결정에 대한 자신감이 향상되는 성과는 있었으나, 수업운영 및 실습을 포함한 보건의료의 세부전공에 대한 교과내용의 보완은 개선해 나가야 할 과제로 나타났다. 본 연구에서 제기된 성과 및 과제를 공유함으로써 진로교육의 정책적 대안이 마련되어야 함을 제언한다.

• 한국의료질향상학회지
• /
• 제28권1호
• /
• pp.45-54
• /
• 2022

Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

• 디지털융복합연구
• /
• 제17권4호
• /
• pp.211-217
• /
• 2019

국내 만성질환 관리에서 모바일 헬스 적용이 임상적으로 유용하다는 보고가 증가됨에 따라, 본 연구는 텍스트 마이닝 기법을 적용하여 국내 외 학술지에 게재된 국내 만성질환자 대상 모바일 헬스 중재연구의 특성 및 중심 키워드의 변화를 파악하고자 시도된 이차분석연구이다. 분석대상 논문은 2005년부터 2018년까지 학술지에 게재된 최종 20편으로, 추출한 텍스트는 Microsoft Excel을 활용하여 논문별 분석을 실시하였고, Text Analyzer를 사용하여 주제어를 추출하였다. 연구결과, 모바일 헬스 중재 연구는 고혈압, 당뇨병, 뇌졸중 관상동맥질환자에 주로 적용되었다. 가장 많이 사용된 중재 유형은 애플리케이션 개발이었으며, 최근 연구에서는 주로 '유용성', '모바일 헬스', '결과측정' 등의 단어들이 가장 많이 출현하였다. 추후 만성질환자 대상 모바일 헬스 중재에 관한 국내 외 연구 모두를 포함하여 주제어 간의 연관성을 확인할 수 있는 사회연결망 분석방법을 적용하여 그 효용성을 확인해볼 것을 제안한다.

• 보건행정학회지
• /
• 제19권4호
• /
• pp.18-32
• /
• 2009

The goal of this study was to predict the health outcomes of lung cancer surgery based on the Charlson comorbidity index (CCI). An attempt was likewise made to assess the prognostic value of such data for predicting mortality, survival rate, and length of hospital stay. A medical-record review of 389 patients with non-small-cell lung cancer was performed. To evaluate the agreement, the kappa coefficient was tested. Logistic-regression analysis was also conducted within two years after the surgery to determine the association of CCI with death. Survival and multiple-regression analyses were used to evaluate the relationship between CCI and the hospital care outcomes within two-year survival after lung cancer surgery and the length of hospital stay. The results of the study showed that CCI is a valid prognostic indicator of two-year mortality and length of hospital stay, and that it shows the health outcomes, such as death, survival rate, and length of hospital stay, after the surgery, thus enabling the development and application of the methodology using a systematic and objective scale for the results.

• 간호행정학회지
• /
• 제4권2호
• /
• pp.321-349
• /
• 1998

Since 1990 the effort for unification has been active in each department of our society. But the study for health policy in Unified Korea has been scarce. Unified Korea should be a democracy and a constitutional state. So we should have lively discussion on the health law as well as unified general laws. The purpose of this study is to compare the health law of South Korea and North Korea and to understand the differences in them. We guess both Korea are considerably different each other. But this study found out that there are many health related laws that have same goals and contents. The reason for this is that both health laws have its root in Korea Law. And the right to health is the social basic right. whose characteristic can not be compatible with market economy and demands state intervention for securing the right to health. The health related laws are divided into 4 fileds. 1. There is a field A which is affected by unified political and economic system and differs little from the law system: the license system of medical personnel. 2. There is a field B which is seldom affected by unified political and economic system and differs little from the law system: the right and duty of medical personnel. quarantine law. 3. There is a field C which is affected by unified political and economic system and differs greatly from the law system: health institution law(exclusive of quarantine law), the laws of medical personnel category, of research center(especially per-mission, registration and establishment). of the role of basic health in private and public area. 4. There is a field D which is seldom affected by unified political and economic system and differs greatly from the law system: health equipment law(the laws of drugs, of cosmetics and of medical instrument. of blood management). the laws of health knowledge. of cooperation in chinese medicine and western medicine. the health promotion law. the rules of first-aid. the law of separation of dispensary from medical practice. The laws which are seldom affected by political and economic system can be consolidated. which in turn can be revised and enacted before unification of Korea through the interchange between North Korea and South Korea and the support to North Korea health system.

• Perspectives in Nursing Science
• /
• 제15권2호
• /
• pp.49-69
• /
• 2018

Purpose: The purpose of this study was to derive contextual indicators of medical provider quality and assess their relative importance along with the individual utilization of antenatal care (ANC) and institutional births with a skilled birth attendant (SBA) in India using a multilevel framework. Methods: The 2015~2016 Demographic and Health Survey (DHS) from India was used to assess the outcomes of neonatal, infant, and under-five child mortality. The final analytic sample included 182,980 children across 28,283 communities, 640 districts, and 36 states and union territories. The contextual indicators of medical provider quality for districts and states were derived from the individual-level number of ANC visits (<4 or ${\geq}4$) and institutional delivery with SBA. A series of random effects logistic regression models were estimated with a stepwise addition of predictor variables. Results: About half of the mothers (47.3%) had attended ${\geq}4$ ANC visits and 75.8% delivered in institutional settings with SBAs. Based on ANC visits, 276~281 districts (43.1~43.9%) and 13~16 states (36.5~44.4%) were classified as "low" quality areas, whereas 268~285 districts (41.9~44.5%) and 8~9 states (22.2~25.0%) were classified as "low" quality areas based on institutional delivery with SBAs. Conditional on a comprehensive set of covariates, the individual use of both ANC and SBA were significantly associated with all mortality outcomes (OR: 1.17, 95% CI: 1.08, 1.26, and OR: 1.10, 95% CI: 1.02, 1.19, respectively, for under-five child mortality) and remained robust even after adjusting for contextual indicators of medical provider quality. Districts and states with low quality were associated with 57~61% and 27~43% higher odds of under-five child mortality, respectively. Conclusion: When simultaneously considered, district- and state-level provider quality mattered more than individual access to care for all mortality outcomes in India. Further investigations are needed to assess the importance of improving the quality of health service delivery at higher levels to prevent unnecessary child deaths in developing countries.

• 한국보건간호학회지
• /
• 제4권1호
• /
• pp.37-55
• /
• 1990

Every country in the world has been trying to expand the basic health right for the peoples as W.H.O has established the goal 'health for AU' by the year of 2000. Related to this goal, our government authority has establish the policy 'the insurance of health for all' into effect from July 198\). Recently hospitalshave been making a ceaseless effort for the plan for the rationalization of its management the academic World is making it a subject of discussion by doing the secure of manpower at a resonable level and the increase of productivity by the manpower. As a result of the efforts the study was established to secure the numbers of nursing manpower at a resonable level and use the unskilled persons at the utilizing field and seek the possible area of their activity for more efficient service through the investigation of ablity of simple nursing activities of regiestered nurses and nurse aides for rational function according to the educational levels and talents. The method of study was established by the registered nurses and nurse and nurse aides(R.N 229, N.A 226) who are working in 15 hospitals with over 200 beds. This surrey was conducted from Mar 29, 1989 to April 8, 1989. The method to test the degree of importance, difficulties, and the abillity of performance of a simple nursing activities was classified into 35 activities on the basis of references on this field. The degree of importance was composed from point l(Not so important) to 5(Very important). the degree of difficulties. was composed as follows; very easy - Point 1 very difficult and complicated - Point 5. and the ability of performance was composed from point 1 to 5. The materials gathered through the survey were analyzed with frequency, mean standard deviation, percentage. t-test, Anova, pearson's coefficient of correlation, stepwise multiple regression. factor analysis, discriminant analysis. The obtained results are summarized as follows: 1. The recognition values of the simple nursing activities of each group of registered nurse and nurse aides show; The degree of importance; 4.04 and 4.26 The degree of difficulties; 2.72 and 2.94 The ability of performance; 2.07 and 2.38 The brief summary shows there are little differences between who two groups the simple nursing activities turned out to be easy and simple work. 2. Regardless of the degree of importance, and difficulties, the ability of performance the important in fluencing of the degree of the simple nursing activities between the registered nurses and nurse aides was the order of educational level, hospital career, working career in wards and ages of the registered nurses and ages and hospital creer of nurse aides. The result was that the simple nursing activities could easily be familiar through the training of their working environment and period of experience. 3. Among the 35 simple nursing activities the items capable of resonable entrusting to the nurse aides are 5 that is helping bed-bathing, 8itz Bath, using bed pan, care while delivering patient, accompaying patient when visitor's check. There wasn't and differences between RN and nurse aides in performing the above 5 items. In anywhere. so we can say obviosuly that this nursing activities should be performed under the nursing system of which chief of nurse are supposed to supervise nurse aides as a possible function to be entrusted. In view of the above mentioned results, therefore, this partial functional job of the simple nursing activities can able be entrusted to the nurse aides through the regular training course. In case of these functional activities could be entrusted under, the responsibility of registered nurse, we can able suggest to for that there are the following advantages: 1.. In the nursing activities-affairs, the qualified guarantee of the nursing services can be kept and increased or promotoed with accommodation of the required nursing service and roles being expanded presently. 2. In the productivity of the hospital manpower, therefore, we have comt to view and consider in favourly that when an automational administration times would be come in the near future time to hospital affairs as a reality, to utilize the existing nures aides is better rather than investing so as to develop the other source manpowers or seek its for the efficient business management in the operational strategy or its policy.