• 한국병원경영학회지
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• 제24권1호
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• pp.11-20
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• 2019

The purpose of this study was to identify the factors affecting the use of superior general hospitals on public holidays by using the medical use model (Dutton's medical use model) with the medical panel data. The study found that 34.2% of superior general hospital emergency rooms were used on public holidays and the factors which made statistically significant influences on the use of superior general hospital emergency rooms on public holidays were whether patients were operated or emergency care and inspection etc. Also, there was a difference depending on whether the type of establishment of the medical insititution is national or private. In other words, patients who received emergency care and examinations were found to make more frequent visit to hospital emergency room on pubic holiday, compared to patients who underwent surgery and those who visited emergency rooms in the private superior general hospital did so, compared to those who visited emergency room in the national general hospital(OR, 4.4, 3.386, respectively). Therefore, it is necessary to consider the introduction of integrated care of health and social care medical service that focuses on primary care in Denmark, which focuses on patients, and pre-The Canadian Triage and Acuity Scale(pre-CTAS) in the UK.

• 한국노년학
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• 제39권1호
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• pp.1-20
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• 2019

최근, 보건복지부가 커뮤니티케어 구축에의 필요성을 강조하면서 보건의료-요양-사회복지계의 뜨거운 관심이 이어지고 있다. 이에 본 연구에서는 향후 노인대상의 커뮤니티모델을 구축함에 있어서 노인장기요양보험이 어떠한 미래적 비전을 갖고 재검토되어야 하는지를 살펴보기 위해 국책사업으로 지역포괄케어시스템(aging in place) 구축을 추진하고 있는 일본의 정책추진사례를 심층적으로 분석해 보는 것은 그 의미가 있다고 볼 수 있으며 본 연구는 일본의 개호보험제도 개정과정을 문헌검토를 통해 심층적으로 분석하였다. 일본의 지역포괄 케어시스템 구축을 위한 개호보험제도 운영현황과 개정과정을 살펴본 결과, 향후 우리의 경우 1)커뮤니티케어시스템 구축의 기본적인 원리를 보다 명확히 할 필요가 있고 2)노인장기요양보험의 재가서비스 확충, 3)거주유형의 다양화 및 고도화 작업 추진, 4)케어매니지먼트체계 구축, 5)당사자와 가족지원 확대 등의 정책추진이 보다 적극적으로 이뤄져야 할 것으로 사료된다.

• 한국직업건강간호학회지
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• 제29권3호
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• pp.192-201
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• 2020

Purpose: This study aims to conduct an integrated literature review of infection control studies conducted by nursing care workers in long-term care facilities in Korea. Methods: Through the domestic search engines RISS and KISS, seven articles were selected by searching for theses and academic journals published in Korea from 2008 to January 2020. Results: In total, six research studies and one intervention study out of seven studies were analyzed. Measurement tools for examining the knowledge and performance of infection-related care workers consisted of skin infection, aspiration pneumonia, urinary tract infection, and hand hygiene. Factors affecting nursing care workers' infection management performance were infection management knowledge, education level, health status, and importance awareness. Conclusion: This study showed it is necessary to develop a tool that can accurately measure nursing care workers' infection management knowledge and performance. In addition, it is necessary to develop an intervention program for nursing care workers' infection control.

• 가정∙방문간호학회지
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• 제14권1호
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• pp.11-17
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• 2007

The purpose of this study was to describe the policy agenda and alternatives for the home health care system in Korea. The home health care system development was not fully integrated while the medical laws were established in 2000, community health law in 1995, and elderly long-term health insurance law in 2007. Because of the increasing population of people over the age of 65 and dramatically decreasing fertility rate, the burden of various health-care expenses has become a great obstacle for the Korean government. Under these circumstances, the home of home health care system in has taken on an important role under the mandate of the national health care system. The types of home health care system in Korean shows a greater contrast from those utilized in other more industrialized countries, such as, U.S. or Japan. In conclusion, the strategy in overcoming the obstacles to enhance home health care system under the national health system would be developing it as a comprehensive and exchangeable consumer-focused organization.

• 한국의료질향상학회지
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• 제24권1호
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• pp.30-39
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• 2018

Objectives: In Korea, there are many kinds of evaluations for medical institutions. However, evaluations are increasingly burdensome for medical institutions because evaluation agencies, evaluation timing, and evaluation methods are different. The purpose of this study is to improve the efficiency of evaluation for medical institutions and ultimately to provide quality medical services to patients. Methods: In this study, 2,310 indicators of 19 kinds of evaluation for medical institutions were analyzed. Results: 1,424 indicators were available for on-site surveys and 886 indicators were not available for on-site surveys. There were 4 kinds of evaluation that can be integrated in total, 12 kinds of evaluation that can be integrated partially, and 3 kinds of evaluation that need to maintain the current evaluation system. Conclusion: In order to provide patient-centered quality medical services through reduction of burden due to the evaluation for medical institutions, it is necessary to deeply discuss the efficiency of evaluation integration and result utilization.

• 농촌의학ㆍ지역보건
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• 제48권3호
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• pp.189-204
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• 2023

Objectives: The goals of this study are to exploring critical factors and methods to improve Korean Community Care through the cases of GyeongsangNamdo. Methods: For this study, we performed in-depth interviews with 90 people involved in Community Care services of 6 regions, and the collected data were analyzed. The collected data were analyzed utilizing NVivo12. In the end, we reconfirmed the process through Topic Modeling analysis. Results: We conducted descriptive statistics and qualitative data analysis collected through surveys and in-depth interviews. In the case of qualitative analysis, we extracted principle codes (Need, Lack, Absence), and sorted the contents into sub-categories. The response rate of 'Need to strengthen capabilities' was the highest, 'Need to communicate and share information' was the second, and 'Need for integrated operation and a control tower' was the third. Conclusion: As a result, we find the critical factors to improve Community Care. Based on them, we should conduct follow-up researches to propose concrete methods to apply to diverse regions.

• 보건행정학회지
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• 제33권3호
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• pp.295-310
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• 2023

Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.

• Journal of Hospice and Palliative Care
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• 제24권4호
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• pp.226-234
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• 2021

Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients' greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion: We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.

• 한국병원경영학회지
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• 제9권3호
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• pp.18-48
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• 2004

Health policies in many countries have come under critical scrutiny in recent years. This is because of increasing national health expenditures. Also many persons in health sector have been the perception that resources allocated to health services are not always deployed in an optimal fashion. And they believe that the scope of resources in health services is limited, there is need to search for ways of using existing resources more efficiently. A further concern has been the desire to ensure access to healthcare of various groups on an equitable basis. In some European countries this has been linked to a wish to enhance patient choice and to make service providers more responsive to consumers, while Korea integrated health insurance funds into single fund in 2000. Many European countries are under considerable pressure to review and restructure their health care systems. There are several reasons of pressure to reform. There are demographic changes, pattern of disease change, advances in medical sciences will also give rise to new demands within the health services, public expectations of health services are rising as those who use services demand higher standards of care. These circumstances require the change of health care delivery system based on hierarchical regionalism, which was basis of health care delivery since 1920s. Korea is also under similarly pressure to restructure our own health care systems. We will have good learning from OECD experiences. In this paper we reviewed and compared among OECD countries' various experiences.

• Child Health Nursing Research
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• 제21권4호
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• pp.293-301
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• 2015

Purpose: This study was done to analyze the effectiveness of simulation-based integrated practice program (maternal-child) on nursing knowledge, self-confidence, and clinical competence of nursing students. Methods: A nonequivalent control group pre-post experimental design was used to compare experimental and control group. The experimental group received the integrated simulation practice and the control group received a separate simulation for maternal care and for newborn care. Results: The experimental group who had the integrated simulation had significantly higher scores for self-efficacy on nursing handover (F=0.480 p=.012) and oxygen therapy in newborn care (F=3.262 p=.037), and for clinical competence (F=2.639, p<.001) and personal satisfaction with debriefing compared to the control group (F=2.179, p=.044). But the experimental group did not have significantly higher scores in nursing knowledge. Conclusions The results indicate that an integrated simulation practice is an effective practice method to improve self-confidence, clinical competence and satisfaction. Also this study had significance in providing a setting similar to the clinical situation.