• 대한간호학회지
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• 제46권4호
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• pp.562-571
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• 2016

Purpose: In this study the costs and benefits of a home health care program were examined to evaluate the economic feasibility of the program. Methods: The study participants included 349 patients in the community who had been registered at a home health care center for 5 years. The costs and benefits of the program were analyzed using performance data and health data. The benefits were classified as the effects of pressure ulcer care, skin wound care and catheters management. The program effect was evaluated on the change of progress using transition probability. Benefits were divided into direct benefit such as the savings in medical costs and transportation costs, and indirect benefits which included saving in productivity loss and lost future income. Results: Participants had an average of 1.82 health problems. The input cost was KRW 36.8~153.3 million, the benefit was KRW 95.4~279.7 million. Direct benefits accounted for 53.4%~81.2%, and was higher than indirect benefits. The net benefit was greater than 0 from 2006 to 2009, and then dropped below 0 in 2010. Conclusion: The average net benefit during 5 years was over 0 and the benefit cost ratoi was over 1.00, indicating that the home health care program si economical.

• 간호행정학회지
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• 제14권4호
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• pp.421-431
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• 2008

Purpose: Using comprehensive and valid instrument, MDS-HC 2.0, this study aimed to analyze the functional status and to evaluate the care needs of the community-dwelling disabled with cerebral impairment. Method: With a convenient sample of 88 disabled with cerebral impairment, the data were collected at a community health center located in rural area in Choongchung providence in August 2005. Subject's functional status and care needs were evaluated using Minimum Data Set-Home Care version 2.0. Result: Significant proportion of subjects were totally dependent for locomotion-outdoor (26.1%), personal hygiene (24.1%), bathing (24.1%). For IADLs, over 40% of subjects were totally dependent for ordinary house work, managing finances, or shopping. Top five ranked care needs were preventive health care measures (100%), communication disorders (71.6%), visual function (55.7%), health promotion (52.3%), and pressure ulcers (48.9%). The proportion of triggered clinical assessment protocols were significantly higher in disability level I group for the risk of institutionalization (p=<.001), communication disorders (p=.004), cognitive problems (p=.001), pressure ulcers (p=<.001), skin and foot conditions (p=.010), and urinary incontinence and indwelling catheters (p=<.001). Conclusions: It is necessary to provide community based rehabilitation services that are individualized for their service needs thus enhance optimal level of functioning.

• 대한영상의학회지
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• 제81권6호
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• pp.1389-1396
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• 2020

목적 본 연구의 목적은 경피적 폴리 카테터 삽입을 이용하여 수술 후 장 누출을 성공적으로 관리하기 위한 기술적 및 임상적 요인을 분석함에 있다. 대상과 방법 이번 후향적 연구에는 32명의 환자가 포함되었다. 수술 후 위장 누출은 컴퓨터단층촬영(CT)을 이용하여 진단되었고, 환자는 Jackson-Pratt 튜브 또는 이미지 유도 방법을 통해 경피적 경로로 누출 위치에 폴리 카테터 삽입을 시행 받았다. 성공은 합병증 없이 폴리 카테터를 성공적으로 제거한 것으로 정의하였고, 임상적 실패와 관련된 인자들에 대하여 분석하였다. 결과 모든 환자에서 경피성 폴리 카테터 배치는 합병증 없이 성공적으로 시행되었다. 폴리 카테터 삽입은 CT에서 누출이 확인된 후 중앙값 10일(범위, 1~68)째에 시행되었다. 임상적 성공은 32명의 환자 중 26명(81%)에서 달성되었다. 통계학적 분석에서, 임상적 실패에 대한 통계적으로 유의미한 위험 인자는 전신적 동반 질환(p < 0.001) 및 구강 섭취 실패(p = 0.015)였다. 결론 경피적 폴리 카테터 삽입은 수술 후 장 누출을 관리하기 위한 안전하고 효과적인 접근방법으로 간주될 수 있다. 폴리 카테터 배치 후, 전신적 동반 질환의 유무 및 성공적인 구강식이를 빠른 시일 내로 시작하는 것은 임상적으로 성공적인 회복에 중요한 요소이다.