• 한국실내디자인학회논문집
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• 제24권3호
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• pp.156-164
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• 2015

Nursing Homes do not have a defined standard in the space area nor does it have a detailed standard facility requirement by law. This can possibly lead to the deterioration of the facility and the system. This directly affects the medical treatment space area within the nursing home. The medical treatment area provides medical treatment to seniors and this is where the seniors get most of their daily services. Therefore, this is research is about the study of the space area of the medical center and the ratio trend of the space area for the medical treatment facility located in senior nursing homes. Ten facilities have been selected in this study to analyze the correlation factors between space area and its trends. The analysis performed includes the conditions relating to the area and what affects the center. We have followed up with a proposal for improvement of the facility and area configuration for the medical treatment facility. Based on the analysis, the following conclusion can be made: First, the senior welfare centers are mostly used as a residence purpose followed a temporary stay of residence facility for the seniors. Second, research indicates that the bigger the facility, nursing and public functions took a larger portion of the space area compared to other services within the senior welfare centers. Third, the study shows the management space area took up about 1%~6% of the entire medical center within the nursing home which is a narrow space area because of the integrated management. Fourth, analysis based on the trend in the time-series indicate after the adoption of the system, there is a continued decline in the space area of nursing, management and public areas. Lastly, since before and after 2008, the space area composition of the nursing facility shows a continuous decline in our study. We can safely conclude that the revised senior welfare act's construction plan has an effect in the facility and is effectively working to meet its requirement. Therefore, the revision of the law is required to reflect the social needs of the residents.

• 대한간호학회지
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• 제24권4호
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

• 가정간호학회지
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• 제13권1호
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• pp.46-53
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• 2006

Chunchoen Community Home Nursing Program (CCHNP) sponsored by Chuncheon City and Gangwondo Nurses Association was the first trial of community based home health nursing in Korea. The services have started since 1996. The purpose of the study was the evaluation CCHNP to establish standard of community based nursing program in Korea. The methods of evaluation were quantitative and Qualitative approaches. Evaluation for organization and management were conducted by the American Community Health Accreditation Program Standards With the result. several recommendations were suggested : It is necessary to expand the program to all the Gangwondo cities. And the liaison system is necessary between medical care facilities and community nursing home agency to establish the continuity of health care delivery system in home nursing program. Also it is necessary to set up the supporting system between community home nursing care agency and hospital home nursing department. Finally, the National Health Insurance should cover the cost of community home nursing care.

• 한국직업건강간호학회지
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• 제14권1호
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• pp.56-70
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• 2005

Objectives: The purpose of this study is to develop a linking model between industrial injury insurance organs and local organizations providing social welfare health services, for the activation of medical rehabilitation services for industrial injury patients. Method: Research design for this study was a multi-step research through literature review, field research, and group interviews with persons in charge, to compare local society-oriented medical rehabilitation programs. The term of researches Sep.1 ~ Nov. 30, 2004. Results: 1. Home nurses from Workers Accident Medical Corporation have been taken to be adequate to case managers, who link industrial accident insurance institutions to local society services for the activation of medical rehabilitation services for industrial injury patients. They have been chosen for case managers because they have richer understanding and experiences of objects of industrial accidents than any other specialists, and because they have proved to be able to provide direct home services as a specialist. We have established the center for case management affairs within the workers accident general hospital, organized the committee for case management with doctors in charge, doctors in rehabilitation, rehabilitation consultants, social welfare workers, physical therapists, and nurses, determined objects of case managements from those of long-term recuperation, and constructed a course of case management containing from case management plans to evaluation. 2. We have made files of community resources, and organized the council of industrial accident administration to have it in charge of the adjustment and linking of services in case management affairs. 3. Because there are inequality of community resources between areas, differences in experiences in and bases for linking, and disparity of core organizations with active linking in the system of linking between public and civil sectors, we have taken a system of linking between parallel organs to be the core. In our linking model, workers accident general hospital, hospitals designated for industrial injury, and rehabilitation hospitals are linked in parallel, inadequate long-term recuperation managers are trusted to an workers accident medical corporations through examination by the examination committee in Korea Labor Welfare Corporation, and are dealt with by the committee for case management. Of the hospitals designated for industrial accidents, those running a home caring center provide home caring services for the handicapped at home from industrial injury. 4. Workers Accident Medical Corporation take part in medical rehabilitation, and Korea Labor Welfare Corporation in vocational/social rehabilitation. Furthermore, in the model, the latter should construct a system for job opportunities through Internet portals and provide cyber vocational consultation and introduction. Conclusion: Improvement of systems is needed to apply the linking model to practical affairs. Because this model is centered for practical affairs, it should be put under the analysis of effects, and evaluation of its adequacy to practical application, and its effects and efficiency through experimental running in the 8 workers accident general hospital in Korea.

• 대한간호학회지
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• 제34권3호
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• pp.449-457
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• 2004

Purpose: The aim of this study was to analyze economical efficiency of home care service by comparing a cost-utility ratio(CUR) between home care and hospitalization. Method: The analytic framework of this study was constructed in 5 stages: Identifying the analytic perspectives, measurement of costs, measurement of utility, analysis of CUR, and sensitivity test. Data was collected by reviewing medical records, home care service records, medical fee claims, and other related research. Result: The mean of the annual total cost was 23,317,636 Won in home care and 73,739,352 Won in hospital care. QALY was 0.389 in home care and 0.474 in hospital care, so CUR was 299,712,545 QALY in home care and 777,841,266 QALY in hospital care. Conclusion: The findings affirmed that home care had an economical efficiency in the aspect of utility compared to hospitalization. Therefore, the findings of this study can be used to develop a governmental health policy or to expand the home care system. In addition, the cost-utility analysis framework and process of this study will be an example model for cost-utility analysis in nursing research. Therefore, it will be used as a guideline for future research related to cost-utility analysis in nursing.

• 보건행정학회지
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• 제8권1호
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• pp.203-230
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• 1998

This purposes of this study is to develope policies on the facilities for the elderly care in Korea. Methodology of this study adopts comparative analysis on the facilities for the elderly care in 6 countries which have experienced various problems on the elderly. These 6 countries are Japan, Sweden, America, Australian, England and Germany. Major issues for comparative analysis are the standard of care facilities, residence condition, finance of facilities establishment and expense, operating system, management, and the law and administrative structure about the facilities for the elderly care. The elderly people need various kinds of welfare services such as medical care facilities, nursing home facilities, home care facilities etc.. Thus the public policies for the aging population nations are compose of income maintenance program, health and medical care services and social welfare services. The policies of facilities for elderly care are very important since these policies include the characteristics of income maintenance, me\ulcorner미 care program and welfare program. This study willsupply basic data for the development of facilities for the elderly care in Korea, especially conceming the system and institutional device of the facilities.

• 근관절건강학회지
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• 제7권1호
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• pp.40-52
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• 2000

Recently with the development in computer technology and its communication system, many changes in medical informatics enable us to use various medical information regardless of time or place. There are many home pages on the web, which provide medical counseling and hospital information. On May 11th 1999, Korean Rheumatology Health Professions Society began its new service as a home page on the web with various rheumatologic health information, questioning/ answering, and so on. This study was undertaken to examine the content and the purpose of health counseling on the web. The data was collected from 173 questioners who visited questioning/ answering site in the KRHPS home page for May 11th, 1999 through November 10th, 1999. Most of the questioners consulted the health problems of their or their families. Over two thirds of them were already diagnosed medically. Rheumatoid arthritis was the most frequent one. Other diseases, such as, osteoarthritis, ankylosing spondylitis, Still's disease were also on the list. Most of the questioners wanted to know treatment strategies, to consult about their symptoms, and to make diagnosis. And many questioners wanted detailed explanations about their diseases or the informations regarding the hospital. These findings suggest that the health counseling on the web may be used to supplement the lack of direct medical interviews with doctors. It also is expected to guide the patients to the right direction.

• 한국산학기술학회논문지
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• 제10권5호
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• pp.1126-1132
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• 2009

본 연구는 가정간호사의 표준간호중재를 개발하여 이를 근거로 각각의 진단과 연결된 중재를 분류하고 프로토콜을 전산화하여 사용함으로써 의료기관간, 또한 의료인간의 격차를 없애고 서비스의 질 개선에 도움을 주고자 시행하였다. 연구방법은 크게 가정간호 표준중재 개발과정과 개발된 가정간호 표준중재 프로토콜을 전산화하는 과정으로 나누었는데, 가정간호 표준중재를 개발하기 위하여 먼저, 국내외 가정간호사의 직무분석, 대상자 사정 프로토콜 개발, 대상자 진단 프로토콜 개발, 대상자 중재 프로토콜 개발의 4가지 연구내용으로 구성하였다. 개발된 가정간호 표준 중재 프로토콜을 전산화하는 과정으로, 크게 가정간호 정보시스템을 위한 전략수립과 가정간호 정보시스템의 분석, 설계, 운영 및 평가 등의 4개 연구내용으로 구성하였다. 개발된 프로그램은 P시에서 가정간호사업 실시 기관에 근무하는 가정간호사를 대상으로, 가정간호 정보시스템 매뉴얼을 사용하여 직접 시범, 교육하였다. 따라서 본 연구에서는 표준 가정간호중재에 속하는 구성요소를 가정간호정보조사지, 가정간호경과기록지, 가정간호경과요약서, 가정간호종결 요약서 양식에 포함될 수 있도록 개발하였으며, 표준 가정간호중재가 개발됨으로써 가정간호사업부서 간의 정보교환이 용이하고 기록의 누락 및 중복을 막을 수 있으며 EMR, HMR 개발시 병원용어의 표준화에 기여할 수 있을 것이다.

• 한국정보통신학회:학술대회논문집
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• 한국해양정보통신학회 2002년도 춘계종합학술대회
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• pp.366-372
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• 2002

Tele-medicine and emergency medical system are necessary for moving from an accidental point or far distance to a hospital and emergency treatment or home treatment before a hospital. Emergency treatment is extremely important in the case of death before arriving a hospital and deformed or disabled by medical treatment delay. A necessary element for this medical system is the emergency communication system. This system is on preparing for an ability of furnishing patient status to a corresponding health service by monitoring the patient at an ambulance of the accident place. This is the transportation of basic biological information of a patient to a medical center by wireless communication system and the corresponding hospital or medical center examine the patient by monitoring, then they can send emergency medical order to the patient for emergency treatment. The TRS is most efficient way of emergency medical communication system, which is currently used with popularity. In this paper studied simultaneously a way of detecting and transporting bio-logical signals, and monitoring of transporting data with communication of voice in the accident place or ambulance.

• 가정간호학회지
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• 제7권1호
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.