• Journal of Home Health Care Nursing
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• v.18 no.1
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• pp.13-19
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• 2011

Purpose: The aim of this study was to evaluate patient satisfaction and indirect marketing effects (recommendation, hospital re-visit intention) and additionally to calculate the expected incomes by clinical nurse specialists (CNS). Methods: Sixty-six patients who had lower varicose vein removal surgery performed at two general hospitals from August 1 to November 30, 2008, were recruited. The effects were evaluated by degree of patient satisfaction, the number of personal recommendations given, rate of hospital re-visit intention, and indirect marketing effects. Indirect marketing effects were calculated as the total cost of surgery multiplied by the score of other variables. Results: The patient satisfaction score was 0.82 for CNS and 0.43 for general nurses (GN). The number of personal recommendations given was 2.5 for CNS and 1.1 for GN. The rate of hospital re-visit intention was 0.31 for CNS and 0.21 fot GN. The ratio of expected incomes between CNS and GN is 2.07 to 1. Conclusion: We found that when a CNS serves a patient, satisfaction, number of personal recommendations, hospital re-visit intention, and indirect marketing effects were higher than those of GN. These results show that CNS have dominant roles and functions and that the effects of CNS employment can be measured using economics parameters.

• Health Policy and Management
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• v.13 no.1
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• pp.1-22
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• 2003

The principal objective of this study was to analyze and conceptualize the socio-psychological burden in utilizing a nursing home for elderly. The subjects were five elderly from a private nursing home located in Seoul and their familial caregivers. An old male and three females were currently staying at the facility, and a female had been discharged already from there. Data were collected through depth interviews, observations and review of records at the facility For analysis, the data were classified by similar contents among significant expressions and factors in common. The subjects' motives to consider admission to the nursing home might be attributed to familial caregivers' burden, a shortage of support, environmental improvement and feeling of helplessness for the case elderly. The concept of burden is including family members' being badly off in living, their weariness, complications among family members, feeling psychological uneasiness, and hospital expenses. The identified image of nursing homes for the elderly in Korea was generally negative at the point of high cost, unreasonable requisites and limitations for admission to the facilities, inferior situations, and especially in that there were few long-term care facilities within the community boundary. From their experience of nursing homes, the interviewees have felt the sentiments of sorry for their old parents, with the thought of being an undutiful, bitterness, and empathy. Additionally, they expressed a sense of anxiety of relative deprivation against the fact that there were no long-term care facilities available for the middle class. On the basis of these, multi-dimensional needs could be identified for the elderly with chronic illnesses.

• Journal of Internet Computing and Services
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• v.12 no.2
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• pp.135-147
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• 2011

As the number of elderly people living alone has been increasing in the recent years, systems for their safety have been required, and some related services or pilot systems have been operating. These systems provide the monitoring service for the activities of the elderly people living alone with indoor location tracking technology using the various sensors. However, most systems provide services on expensive infrastructure such as attached tags and mobile devices. In this point, this paper attempts to suggest a system based on low cost sensors to collect event data in home environment. And a main characteristic of the system is that people can monitor the results of provided services through web browser in real time and the system can provide related context information to guardians and health care managers through SMS of mobile phone.

• Journal of Families and Better Life
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• v.21 no.4
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• pp.103-116
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• 2003

The purpose of this study was to examine the economic status of retired elderly households. This study especially looked for the differences in the economic status among retired elderly households and the level of subjective financial strain. The data were drawn from the data of 2000 Korean Labor and Income Panel Study (KLIPS) conducted by the Korea Labor Institute. The major findings are as follows: 1) The levels of income in the retired households were found to be lower than those of the employed elderly households, and the transfer income took the biggest portion out of 5 income types reflecting high economic dependency. 2) The levels of expenditure were found to be similar to the minimum living cost, and the food cost at home was 41.9% of the expenditure. 3) About 40% and 27.3% of households reported that they felt financial strain due to food expenditures at home and health care respectively. 4) Ninety percent of all assets were found to be real estate, reflecting the lack of asset liquidity. Further, retired elderly households were classified as 'not at all strained financially', 'moderate', 'seriously strained', and 'extremely strained' groups according to their subjective assessment. The last two groups showed the lower level of income and expenditures than the first two groups. In particular, 26.5% of retired elderly households belonged to 'extremely strained' group and showed very serious economic problems.

• Journal of Home Health Care Nursing
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• v.10 no.1
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• pp.58-72
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• 2003

The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

• International journal of advanced smart convergence
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• v.1 no.2
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• pp.1-11
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• 2012

IP-based Wireless Sensor Networks (IP-WSNs) are gaining importance for their broad range of applications in health care, home automation, environmental monitoring, industrial control, vehicle telematics, and agricultural monitoring. In all these applications, a fundamental issue is the mobility in the sensor network, particularly with regards to energy efficiency. Because of the energy inefficiency of network-based mobility management protocols, they can be supported via IP-WSNs. In this paper, we propose a network-based mobility-supported IP-WSN protocol called mSFP, or the mSFP: "Multicasting-supported Inter-Domain Mobility Management Scheme in Sensor-based Fast Proxy Mobile IPv6 Networks". Based on [8,20], we present its network architecture and evaluate its performance by considering the signaling and mobility cost. Our analysis shows that the proposed scheme reduces the signaling cost, total cost, and mobility cost. With respect to the number of IP-WSN nodes, the proposed scheme reduces the signaling cost by 7% and the total cost by 3%. With respect to the number of hops, the proposed scheme reduces the signaling cost by 6.9%, the total cost by 2.5%, and the mobility cost by 1.5%. With respect to the number of IP-WSN nodes, the proposed scheme reduces the mobility cost by 1.6%.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.16-24
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• 2005

Objectives : To help develop strategies to cope with the changes arising from the rapid aging process by predicting the determining factors of intention to actual use of the charged long-term care services for elderly as perceived by the middle aged who play the major role of supports. Methods : Subjects were the parents (men 177, women 507) in their 40s of the students selected from a university of Busan city. A questionnaire survey was conducted for 4 weeks in October 2003 about the knowledge for long-term care service, the intention of actual use, and the preferences about the type of service suppliers. Data analysis was performed with frequency, chi-square test, and t-test using SPSS program (ver 10.0K), along with data mining using decision tree of Enterprise Miner V8.2 by SAS. Results : About half of the subjects (53.7%) had the actual experiences of elderly supports. Intentions to use the charged services were relatively high in home visiting nursing care service (40.1%) and long-term care facilities service (40.4%), and were influenced by previous knowledge about the services. The intentions were stronger in women, those with higher education, and those with greater income levels. Actual elderly supports were mostly (80%) done by women, and the perceived burdens for the supports were bigger in women and those of lower socioeconomic level. Desired charges were about 10,000 won for the bath service, 20,000 won for the rests services per day, and about 500,000 won for the long-term care facilities service per month. From the result of decision tree analysis, the job professionalism was the most important determining factor of intention to actual use of the services with validation as $63{\sim}71%$. Health and welfare mixed type facilities were preferred, and the most important consideration was the level of professionalism. Conclusions : Intention to actual use of the charged services was largely determined by the aspects of time and cost. Polices to increase the number of service suppliers and to decrease the burdens perceived by actual supporters were strongly recommended.

• Korean Journal of Hospice Care
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• v.1 no.1
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4901-4903
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• 2015

The gynecologic oncology patients surveillance network program was conducted with the collaboration of 5 provincial hospitals located in the north of Thailand (Chiang Rai, Lamphun Nan, Phayao and Phrae). The aim was to identify ways of reducing the burden and the cost to the gynecologic cancer patients who needed to travel to the tertiary care hospital for follow up. The clinical data of each patient was transferred to the provincial hospital by the internet via the website www.gogcmu.or.th. All the general gynecologists who participated in this project attended the training course set up for the program. From January 2011 to February 2014, 854 patients who were willing to have their next follow-up at the network hospitals close to their home were enrolled this project. Almost of them were residents in Chiang Rai province and the most common disease was cervical cancer. After the project had been running for 1 year, 604 of the enrolled patients and 21 health-care personnel who had participated in this project were interviewed to assess its success. Some 85.3% of the patients and 100% of the health-care personnel were satisfied with this project. However, 60 patients had withdrawn, the most common reason being the lack of confidence in the follow up at the local provincial hospital. In conclusion, it is possible to initiate a gynecologic oncology patients' surveillance network program and the initiation could reduce the problems associated with and the cost the patients incurred as they journeyed to the tertiary care hospital.