• Title/Summary/Keyword: Home health care cost

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Secondary Analysis on Pressure Injury in Intensive Care Units

  • Hyun, Sookyung
    • International journal of advanced smart convergence
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    • v.10 no.2
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    • pp.145-150
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    • 2021
  • Patients with Pressure injuries (PIs) may have pain and discomfort, which results in poorer patient outcomes and additional cost for treatment. This study was a part of larger research project that aimed at prediction modeling using a big data. The purpose of this study were to describe the characteristics of patients with PI in critical care; and to explore comorbidity and diagnostic and interventive procedures that have been done for patients in critical care. This is a secondary data analysis. Data were retrieved from a large clinical database, MIMIC-III Clinical database. The number of unique patients with PI was 2,286 in total. Approximately 60% were male and 68.4% were White. Among the patients, 9.9% were dead. In term of discharge disposition, 56.2% (33.9% Home, 22.3% Home Health Care) where as 32.3% were transferred to another institutions. The rest of them were hospice (0.8%), left against medical advice (0.7%), and others (0.2%). The top three most frequently co-existing kinds of diseases were Hypertension, not otherwise specified (NOS), congestive heart failure NOS, and Acute kidney failure NOS. The number of patients with PI who have one or more procedures was 2,169 (94.9%). The number of unique procedures was 981. The top three most frequent procedures were 'Venous catheterization, not elsewhere classified,' and 'Enteral infusion of concentrated nutritional substances.' Patient with a greater number of comorbid conditions were likely to have longer length of ICU stay (r=.452, p<.001). In addition, patient with a greater number of procedures that were performed during the admission were strongly tend to stay longer in hospital (r=.729, p<.001). Therefore, prospective studies focusing on comorbidity; and diagnostic and preventive procedures are needed in the prediction modeling of pressure injury development in ICU patients.

A Study on the characteristics of Chinese medical care consumers and choice of medical care providers (중국 현지 의료소비자의 특성 및 의료기관 선택 연구)

  • Kim, Ji Man;Lee, Sang Gyu;Shin, Jaeyong;Song, Joo Young;Lee, Ye Seol;Kim, Tae Hyun
    • Korea Journal of Hospital Management
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    • v.23 no.1
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    • pp.78-86
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    • 2018
  • Purposes: This study identifies local Chinese consumers' standard for selecting medical care provider and their standard for choosing medical staff, as well as their expectations and concerns regarding Korean medical care providers. Methodology: A survey was conducted in China, to identify Chinese medical care consumers' standards for selecting a medical provider and the factors that influence their use of general hospitals. A total of 1,500 people across three cities, between the ages 18 and 60 participated in the survey. Moreover, a multiple logistic regression analysis was used to analyze the factors that affect Chinese medical care consumers' use of general hospitals. Findings: A total of 75.5 percent respondents chose general hospitals as their most frequently-used medical provider. Those who have health insurance, visit general hospitals as outpatients or are hospitalized more frequently than those who do not have a health insurance. Furthermore, those who have private insurance visit general hospitals as outpatients or are hospitalized more frequently than those who are not signed up for private insurance. Major standards for selecting a hospital included: the doctor's skills, word-of-mouth regarding the hospital, and distance to the hospital from the respondents' home. Standards for choosing medical personnel included word-of-mouth regarding the medical team, recommendations from family members or acquaintances, and medical team's notoriety. Friends and neighbors, family members, television and other media outlets were the channels for acquiring information on a hospital. It was found that Chinese people mostly visit the cardiovascular department of Korean hospitals for treatment. For using Korean hospitals in China, the majority of respondents answered that they were concerned about the cost. Practical Implications: Backed by highly skilled medical experts and cutting-edge technology, Korean medical care providers are attempting to enter China's medical care market. To succeed in China's medical care market, it is vital to conduct a clear and precise analysis.

Hospice Medicine and Nursing Ethics (호스피스의료와 간호윤리)

  • Moon, Seong-Jea
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.385-411
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    • 2008
  • The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

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A Research Study on 60Years Old People Management of Hypertension. (60세이상의 노인들의 고혈압 치료기관별 비용효과 분석과 관리능력에 관한 비교연구)

  • Cho Hyun;Moon Sun Soon;Jung Kyung Im;Hyun In Sook
    • Journal of Korean Public Health Nursing
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    • v.10 no.1
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    • pp.95-105
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    • 1996
  • This study was uncertaken to find an effective management modality for patients with hypertension. Patients 60years or older were selected for this purpose from a general hospital and a welfare center in Pusan and from a public health clinic in Cheju Island. During the month of October in 1984. the management modality for hypertension. the incurred medical expenses. and knowledge about the hypertension were analyzed and compared. The following results were obtained: 1. The a erage total medical expense per year was highest at the general hospital followed by the public health clinic and the welfare center. 2. It was found that the patients chose the public health clinic for its low medical cost. the welfare center for its proximity as well as for its low medical cost. and the general hospital for its quality medical services Also. the study has shown that the prescription of drugs was the major service provided by the public health clinic whereas the blood pressure measurement. the prescription of drugs. and family planning were the primary service offered by the welfare center. Drug prescription and blood pressure measurement were two of the most important services by the general hospital. 3. It was shown that the knowledge of hypertension was highnest at the welfare center whereas the management of hypertension was highest at the public health clinic. Based on above results and considering the chronic nature. it is believed that family awareness of the illness was one of the most important aspects for effective management of the hypertension for the elderly patients. In addition. the health care clinics at every level should come forward to execition of the educational programs and home nursing schomes for the effective management of the hypertension patients.

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A study on dental professionals' recognition on a system of long-term care insurance for the elderly (노인장기요양보험제도에 관한 치과종사자의 인식도 연구)

  • Ahn, Kwon-Suk;Ji, Min-Gyeong;Min, Hee-Hong
    • Journal of Korean society of Dental Hygiene
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    • v.9 no.1
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    • pp.169-180
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    • 2009
  • This study grasped recognition on a system of long-term care insurance for the elderly targeting dental professionals who are working at dental hospitals and clinics where are located in Daejeon Metropolitan City. It developed and utilized materials available for educating the care staff in a system of long-term care insurance for the elderly and the dental professionals who participate in the oral hygiene service. It carried out the effective duty performance for the elderly in a situation of long-term care protection. Thus, the purpose of this study was to contribute to the early settlement in a system of long-term care insurance for the elderly. The following conclusions were obtained as a result of having carried out self-administered questionnaire research targeting 238 people from August 1 to August 30 in 2008. 1. In the general characteristics of the research subject, the present working place was indicated to be 22.7% for dental hospital, 71.8% for dental clinic, and 5.5% for others. As for the main duty field, the medical treatment & cooperative duty was indicated to be the highest with 61.8%, and was statistically significant(p=0.000). 2. The necessity for a system of long-term care insurance for the elderly was indicated to be 77.7% for 'necessary' and 1.7% for 'unnecessary,' and was statistically significant(p=0.016). 3. In the item of dividing the service of long-term care insurance for the elderly, the dental hygienists showed higher recognition than non-dental hygienists, and indicated significant difference(p=0.010). 4. As for recognition on a system of long-term care insurance for the elderly in dental professionals who responded as saying of 'knowing name and contents' about a system of long-term care insurance for the elderly, the recognition level was high in recognition of subjects' age(p=0.000), division in services(p=0.012), contents in at-home care service(p=0.000), execution in oral-hygiene service(p=0.004), procedure of using the long-term care insurance for the elderly(p=0.016), item of judging grade of long-term care insurance for the elderly(p=0.013), medical charge by service according to judging grade of long-term care insurance for the elderly(p=0.015), burden of cost for a system of long-term care insurance for the elderly(p=0.011), qualification of care staff(p=0.002), and contents of oral-hygiene service(p=0.027), and showed significant difference. 5. The service of long-term care insurance for the elderly and the oral-hygiene service indicated the statistically significant correlation. Accordingly, all of dental professionals need to make a desperate effort to improve dental professionals' knowledge on a system of long-term care insurance for the elderly enough to be required a system of long-term care insurance for the elderly. The more systematic and standardized professional education and materials are thought to be needed to be developed aiming at the success in oral-hygiene service within a system of long-term care insurance for the elderly, by strengthening professionalism in dentists and dental hygienists.

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A Study on the Utilization of a Rural Health Subcenter for Primary Health Care (일개 농촌지역주민의 면보건지소 이용실태에 관한 고찰 -경기도 남양주군 수동면-)

  • Kim, Young-Bok;Wie, Cha-Hyung
    • Journal of agricultural medicine and community health
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    • v.19 no.1
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    • pp.31-39
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    • 1994
  • We carried out this study by analyzing the annual reports, surveyed by medical college student(Ewha Woman's University) through the medical records of new patients of Su-Dong Myon Health Subcenter from 1982 to 1992, and the specific survey data of 247 in Su-Dong Myon area which consists of 5,454 population and 1,651 household(43.6% farm household), in December, 1993. Results were as follows: 1) The number of population in Su-Dong Myon is 5,265 in 1982, 4,905 in 1984, 4,885 in 1986, 4,820 in 1988, 4,663 in 1990, 5,454 in 1992. 2) Since 1982, the annual utilization rate of a rural health subcenter showed decreasing tendency: such as 609(the highest rate) per 1,000 inhabitants in 1982, 485 in 1984, 525 in 1985, 281 in 1988, 316 in 1990 and 197 in 1992. The utilization rate by sex was decreasing chronologically in male, and age-specific utilization rate showed rapidly decreasing tendency since 1982 : 1,037 per 1,000 inhabitants in 1982, 877 in 1984, 1,084 in 1986, 519 in 1988, 538 in 1990 and 333 in 1992, in age group of 0-14, but not changing tendency in age-groups of 65 and over. 3) The monthly utilization rate of a rural health subcenter showed increasing tendency in March, July and August from 1982 to 1987, and in March and May from 1988 to 1992. 4) The patient rate of medical insurance showed increasing tendency since 1983: 17.0% per 100 patients(the lowest rate) in 1983, 21.3% in 1985, 20.4% in 1987, 70,0% in 1989 and 77.8% in 1991. However, the patient rate of Medicaid showed no specific change. 5) The utilization rate by the remedial measures for primary health care showed 30.8% of the answered in private special clinic, the highest rate, and 30.0% in drug stores, 25.5% in health subcenter, 10.5% in hospital and 1.2% in oriental clinic. In favorite physicians for primary health care, specialist was the highest rate, 48.6% of the answered, and general practitioner, 39.7% and home doctor, 8.9% in next order. And 70.8% of the answered experienced to visit the health subcenter more than once. 6) Disfavorite reasons of health subcenter were insufficient equipment(42.1%, the highest), and the next order, short cure time per day(25.1%), "be not cured"(12.2%), "be not(6.9%) and unkindness(3.6%), And the major obstacles in utilizing the medical facilities for primary health care were farm works(41.7%, the highest), distance(27.1%) and medical cost(11.4%).

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The Recognition about Food Wastes Treatment at Yongin Area

  • Kim, Jeong-Hyun;Kang, Hee-Joo;Kim, Kyung-Tae;Kim, Hyun-Soo;Hwang, Seong-Hee;Kim, Yong-Chul;Kim, Pan-Gyi
    • Journal of Environmental Health Sciences
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    • v.30 no.4
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    • pp.329-343
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    • 2004
  • We conducted to investigate citizen's attitude to the treatment of food waste in Yongin city. The respondent of $41.81\%$ throws the food waste eliminate from home and store less than 1l in Yongin. When they dump the food waste, they speak out the inconvenience of damaged envelope by animals in case of home and store. This caused troubles for reason of sanitary. So a local autonomous entity must carefully consider of expand use specially designed container as like apartment house. They give an answer that the collecting time of food waste is suitable form dawn till morning. This answer shows the satisfaction of the period time to collect the food waste. They prefer to be appointed the exclusive place to collect food waste. The service interval of collect is suitable 1 time a day. They want to increase the number of washing of the collecting container. This is good method for sanitary condition, but the care of the period time to collect the food waste is more efficient than the care of the number of washing the collecting container. The care of the period time minimizes to incur the enmity of the people and to pollute in environment. The major of respondent handled the food waste after keeping the basket or a kit. This fact shows to us almost citizen doesn't feel the seriousness to remove the moisture of the food waste. Recently, many solutions which can be disposal efficiently are getting magnified and improved owing to increase utilities channel to loss in quantities and dry the food waste. We expect the reduction of food waste is solved getting easily step by step. The results of the awareness about the facility of food waste show citizen prefer recycling facility to the other facilities. If recycle facility and incineration facility are constructed, they were worried about bed smell. When some facility of the food waste is constructed, they have to maintain and to handle not to incur the enmity of the people. The spread rate of specially designed container already increased, the citizen set a high value on the use of specially designed container more than amount-rate vinyl envelope that people have used for several years. In the cost treatment about food waste, the major respondent answered the use cost of specially designed container is suitable price. So we can know the use charge is proper level. The majority of citizen more prefer autonomous plan which voluntary atmosphere creation and public information by mass media than levy system and rising treatment cost which forced plan. The citizens have pretty positive thinking of incineration, so the government needs more efforts for a public notice, which includes the incineration is no more than abandoned thing. Each of local self government has to sort the food waste and make kind of resource system related to collecting and carrying, constructing a suitable facility, proper disposal of the food waste and producing harmless in our surrounding in order to solve the invisible problems. To do above mentioned things, we have to analyze referred several problems till now. Also, to minimize the side effect, the government will have to improve through enforce the system.

Development of Nursing Costs by Nursing Activities in Clinical Nurse Specialist (전문간호사 간호행위에 관한 간호수가체계 개발)

  • Kim, Yoon-Hee;Lee, Hyang-Yeon;Han, Sang-Sook;Shin, Hye-Sook;Lee, Myung-Hee;Kim, Sook-Neoung;Lee, Hye-Jin;Kim, Hye-Sook;Choi, Hyes-Sun
    • Journal of East-West Nursing Research
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    • v.13 no.2
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    • pp.197-207
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    • 2007
  • Purpose: This study was carried out to deveop nursing costs and to substantiate the application of appropriate activity-based nursing costs for the current clinical nurse specialists. Method: The study sample was a group of 8 home health care team of the tirtiary Hospital in Korea. The data was collected from September 2003 through December 2004. The statistical analysis was done by SPSS PC 11.0 program and calculated mean and the standard deviation. In Lee(2003)'s nursing activity analysis, nursing activities were classified into two major classification, 19 domains and 70 activities. Each activities was calculated using its work validity, physical effort, psychological effort, stress as a intensity, and the necessary time. The simple work costs was calculated the work wage per minute and the necessary time. The work load intensity was calculated using the work wage per minute and the necessary time work load intensity/100. Results: In this study, the work wage was 283 won per minute. The work validity ranged from 2.71-4.00. The highest simple work cost/work load intensity cost was 12,735won/47,374won for research activity, 10,700won/27,499won for bedsore care, and 9,727won/35,114won for deathbed care. The lowest simple work cost/work load intensity cost was 2,123won/2,038won for intramuscular injection, 2,210won/2,166won for hypodermic injection, and 2,210won/1,547won for a application of medicine(or ointment or cream). Conclusions: It revealed that the nursing cost should be considered validity, physical effort, psychological effort, stress as a intensity, and necessary time. Therefore, It is necessary to calculate nursing cost systematically based on activities.

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Development of a Remote Wheelchair Accessibility Assessment System Using Virtualized Reality Technology (가상현실기술을 이용한 원격휠체어접근성평가시스템의 개발)

  • Kim, Jong-Bae
    • 한국HCI학회:학술대회논문집
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    • 2006.02a
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    • pp.33-39
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    • 2006
  • Home modification has come to be recognized as an important intervention strategy to manage health care conditions, maintain or improve functioning, ensure safety, and reduce the wheelchair user's dependency on others. However, the availability of skilled professionals with experience in home modifications for accessibility is limited. A system that enables accurate remote assessments would be an important tool to improve our ability to perform home assessments more easily and at decreased cost. A Remote Wheelchair Accessibility Assessment System (RWAAS) using Virtualized Reality(VR) technology was developed that enabled clinicians to assess the wheelchair accessibility of users' built environments from a remote location. Characteristics of the camera and 3D reconstruction program chosen for the system significantly affect its overall reliability. In this study, we performed two reliability analyses on the hardware and software components: 1) Verification that commercial software can construct sufficiently accurate 3D models by analyzing the accuracy of dimensional measurements in a virtualized environment; 2) comparison of dimensional measurements with four camera settings. Based on these two analyses, we were able to specify a consumer level digital camera and the Photomodeler Pro software for this system. And we then tested the feasibility of the selected software and hardware in an actual environment. Lastly, A field evaluation was performed to test whether this new system is comparable to the traditional method of accessibility assessment to evaluate its ability to assess the accessibility of a wheelchair user's typical built environment. The results of field trials showed high congruence between the assessments by two methods. Findings suggested that the RWAAS assessments have the potential to enable specialists to assess potential accessibility problems in built environments regardless of the location of the client, home, or specialist.

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CardioSentinal: A 24-hour Heart Care and Monitoring System

  • Gao, Min;Zhang, Qian;Ni, Lionel;Liu, Yunhuai;Tang, Xiaoxi
    • Journal of Computing Science and Engineering
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    • v.6 no.1
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    • pp.67-78
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    • 2012
  • People are willing to spend more for their health. Traditional medical services are hospital-centric and patients obtain their treatments mainly at the clinics or hospitals. As people age, more medical services are needed to exceed the potentials of this hospital-centric service model. In this paper, we present the design and implementation of CardioSentinal, a 24-hour heart care and monitoring system. CardioSentinal is designed for in-home and daily medical services. It mainly focuses on the outpatients and elderly. CardioSentinal is an interdisciplinary system that integrates recent advances in many fields such as bio-sensors, small-range wireless communications, pervasive computing, cellular networks and modern data centers. We conducted numerous clinic trials for CardioSentinal. Experimental results show that the sensitivity and accuracy are quite high. It is not as good as the professional measurements in hospital due to harsh environments but the system provides valuable information for heart diseases with low-cost and extreme convenience. Some early experiences and lessons in the work will also be reported.