• 보건행정학회지
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• 제24권4호
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• pp.304-311
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• 2014

This manuscript treats a new paradigm for the Korean health care system. We give an account of innovative health care delivery and payment models widely discussed in the contemporary US accountable care organization and coordinated care organization. In doing so, we explore a new health care model amenable to foreseeable changes to the health care system. We propose creating an integrated health care system in which the network of health care providers delivers coordinated and comprehensive care for enrolled patients residing within the geographic boundaries served by the provider network; providers may participate voluntarily in one or more networks and assume shared responsibility for patient care and cost; provider networks compete with each other based on cost and quality; and consumers are allowed to choose a network. We expect that the new paradigm will create a financially-sustainable system that assures quality of care and improves patient experience, minimizing the existing system-wide inefficiency through cross-network competition and within-network care coordination.

• 가정간호학회지
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• 제26권3호
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• pp.253-264
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• 2019

The aim of this review is to present a German system of an outpatient care center under the German Health Insurance Act and home care (integration of medical care, basic care, bathing) under the Long-Term Care Insurance Act. This idea of a German integrated home care system should contribute to the development of a Korean home care model. Prior the introduction of long-term care insurance (1995), and with the of the health insurance law (1989), German outpatient care centers already provided medical and basic care services for patients with acute and chronic symptoms. Since 1995, patients with acute symptoms and rehabilitation periods under the Health Insurance Act have been eligible for home care. The Long-Term Care Insurance Act is intended for all citizens who are unable to carry out their daily activities for more than six months. In 2017, 13,657 (97%) of 14,050 outpatient care centers provided home care services after long-term care and health insurance. In other words, patients in Germany can use home care in both the acute and chronic phase at the same home care center, or 'integrated home-care center'.

• 한국정보전자통신기술학회논문지
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• 제2권4호
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• pp.73-80
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• 2009

본 논문에서는 유비쿼터스 헬스케어와 지능형 홈 네트워크 시스템을 위한 전력선 통신과 Zigbee 통신 기반의 통합 게이트웨이를 구현하였다. 전체 시스템은 센서, 통합 게이트웨이, Zigbee 모듈, 전력선 모뎀으로 구성되어있다. 헬스케어 센서에 의해서 수집된 데이터는 통합 게이트웨이에서 저장 및 분석하여 헬스케어제어장치로 전송할 수 있으며, 의료시설 및 각 가정에 쾌적한 환경을 제공하기 위하여 가전 기기를 제어한다. 구현된 통합 게이트웨이는 다양한 유비쿼터스 헬스케어와 지능형 홈 네트워크를 지원할 수 있다.

• 한국병원경영학회지
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• 제14권2호
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• pp.60-74
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• 2009

This study purports to verify managerial effectiveness of the integrated delivery system(IDS) of Japanese health care institutions through comparing the managerial performance between hospital groups providing with both acute and nursing care and those with acute care only. Data on the managerial performance of 697 hospitals providing with nursing care together and 819 hospitals providing with acute care only were collected from Japanese Central Social Insurance Medical Councils 2001, 2003, 2005, and were analyzed using mean comparison test(t-test) between the two groups. The results revealed that there were significant differences between the two groups in such indicators as ratio of material cost, labor cost, depreciation rate, total margin, operating margin, average number of outpatient per day, average revenue of an inpatient per day, total amount of labor cost, gross revenue per employee, and labor productivity. However, we could not find out any consistent evidence which support the effect of integrated delivery system on the hospital managerial performance. Further discussion was made on the limitation of the study and future research agenda relevant to the topic.

• 한국콘텐츠학회논문지
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• 제11권2호
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• pp.367-375
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• 2011

본 연구는 분절적이고 파편화되어있는 보건 의료 복지서비스를 국내외 통합케어에 대한 사례분석을 통하여 우리나라에 적합한 통합케어 시스템 구축을 위한 기초자료를 제공하고자 한다. 사례분석 결과 통합케어의 공통된 요소는 기관과의 협력, 다양한 전문직의 공동참여, 조정과 개별화된 보호 제공, 사례담당 전문가를 통한 다양한 서비스를 제공하고 있다는 것이다. 이러한 사례를 근거로 우리나라 통합케어 시스템 구축을 위한 제언으로는, 통합케어종합지원센터 설치, 서비스제공 장소의 동일배치, 케어 매니지먼트 체계 구축, 자원개발 및 인력확충, 통합케어 사례관리 시스템 개발, 통합케어 전산망 개발 등이 필요하다.

• 보건의료산업학회지
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• 제13권3호
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• pp.53-65
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• 2019

Objectives: This descriptive survey study aimed to identify factors that affect job satisfaction among nurses working in integrated nursing care service wards and to explore measures to increase job satisfaction among these nurses. Methods: Data were collected between July 20 and August 3, 2018 from nurses working in integrated nursing care service wards in Busan and Changwon city, in Korea. Data were analyzed with SPSS/WIN 23.0 software(IBM corp., Armonk, NY, USA). Results: Factors affecting job satisfaction among nurses working in integrated nursing care service wards were identified as follows: professional self-concept (${\beta}=.32$, p=.003), which is a subdomain of nursing professionalism, and nursing foundations for quality care (${\beta}=.30$, p=.001), which is a subdomain of nursing work environment. The model had an explanatory power of 54.7%. Conclusions: Nursing professionalism should be strongly established among nurses, as nurses are key players in a health system that allows stable and expanded operations of integrated nursing care. Intervention measures that create a better work environment for nurses should also be implemented. Furthermore, it is necessary to develop systematic strategies and multifaceted efforts to increase nurses' job satisfaction in integrated nursing care service wards.

• 보건행정학회지
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• 제33권4호
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• pp.479-488
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• 2023

Background: By applying the suggested criteria for needs-based chronic medical care and long-term care delivery system for the elderly, the current status of delivery system was identified and regional delivery systems were categorized according to quantity and quality of delivery system. Methods: National claims data were used for this study. All claims data of medical and long-term care uses by the elderly and all claims data from long-term care hospitals and nursing homes in 2016 were analyzed to categorize the regional medical and long-term care delivery system. The current status of the delivery system with a high possibility of transition to a needs-based appropriate delivery system was identified. The necessary and actual amount of regional supply was calculated based on their needs, and the structure of delivery systems was evaluated in terms of the needs-based quality of the system. Finally, all regions were categorized into 15 types of medical and care delivery systems for the elderly. Results: Of the total 55 regions, 89.1% of regions had an oversupply of elderly medical and care services compared to the necessary supply based on their needs. However, 69.1% of regions met the criteria for less than two types of needs groups, and 21.8% of regions were identified as regions where the numbers of institutions or regions with a high possibility of transition to an appropriate delivery system were below the average levels for all four needs groups. Conclusion: In order to establish an appropriate community-based integrated elderly care system, it is necessary to analyze the characteristics of the regional delivery system categories and to plan a needs-based delivery system regionally.

• PNF and Movement
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• 제11권2호
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• pp.77-85
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• 2013

Purpose : The purpose of this study is to investigate the effects school business hospital-based integrated health education on learning transfer factor and level. Methods : This study conducted a questionnaire survey of 60 students at D college using metastatic diagnostic tool who took the integrated health education curriculum, statistical analysis utilized the SPSS 17.0 for window version. Results : On comparison of the details 5 clauses, 29 questions using LTSI, this study found that the integrated health education based on the school business hospital is effective for learning transfer. Conclusion : What the integrated health education based on clinic practice system at D college to overcome the limitations of health and medical line is effective for learning transfer and it will be useful to cultivate professional.

• 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.

• 가정간호학회지
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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.