• 가정∙방문간호학회지
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• 제10권1호
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• pp.5-14
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• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• 여성건강간호학회지
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• 제2권1호
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• pp.25-39
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• 1996

The Korean government has a new system for charging patient care for patients in hospital, on hold for the present(9 / 1995) but to start implementation in certain areas of patient care next year. From the latter half of next year the Ministry of Health and Welfare would like to start demonstration projects for hospitals who want to start using DRGs for frequently seen medical diagnosis and for patients with a course that is predictable and for whom non-insurance costs are minimal : such as the patient who has a delivery, cesarean deliveries, cataract surgery, tonsillectomy or an appendectomy, and apply the DRG system of payment for hospital care for these patients. The purpose of this study was to establish a recording system to give effective home health care to postpartum women and their newborns. Recently the government announced a DRG system to apply to postpartum women for pilot purposes starting next year. This gives impetus to the need to develop home care records that will allow for systematic recording and provide continuity and consistency in care across all health professionals and with in-depth communication between the professions to assure high quality care. There has been a rise in medical costs and a shortage of patient bed space in hospitals, particularly since the introduction of national medical insurance. The study focused on developing client selection criteria, a primary assessment tool, progress notes and nursing diagnoses applicable to postpartum and newborn clients. Selection criteria for home health care, assessment tool content, nurses progress notes and diagnoses were developed through a review of the literature, advice from professionals who are expert in home health care and actual practice in the use of recording tools through workshops. The recommendations based on the research results are as follows : 1) Replication and application of these tools is needed to test the validity of the tools 2) In order to have systematic nursing records standardization of records has to be done after nurses have had experience using them. 3) Reliability and validity of the tools has to be established through applicability to actual care situation.

• 지역사회간호학회지
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• 제6권1호
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• pp.34-54
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• 1995

Occupational health services in Korea have been operated as dual types: one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative. health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area: 154 places (39.4%) managed by designated. health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation due to the characterstics of each variable and analyzed for impacting factors with relation to the using multiple regression analysis using SPSS PC program, especially using t -test method in order to compare each type of health care management. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. The common sickness management is the most accomplished item in health care area of occupational health care services, while the preventive care and control for the workers who have serious health problems are insufficient in workers health care area. 3. An insufficient accomplishment of overall health education has been shown because it is difficult to perform health education due to almost no chance of the direct introduction at workplaces. Therefore a strong support system for making and supplying the media is necessary in order to activate indirect health education by means of media. 4. Because health care managers and the agencies managers where take the workplaces for this study are almost nurses who have been comparatively high work site rounding rate about an environmental management at the workplaces, that non-profession can also do it, the activities about the professional area not enough. Therefore, an appropriate referral system should be established in order to complement professional area. 5. Two factors which have an effect on the coverage rate of occupational health care services are : one is those from the workplaces such as type of services, the number of workers, the number of harzadous factors and safety & health committee, the other from health care organization about whether there is its own manager or not.

• 보건행정학회지
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• 제31권1호
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• pp.17-23
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• 2021

With the introduction of national health insurance, the burden of health care costs decreased and choices of medical services widened. However, because of the rapid expansion of non-covered medical services by health insurance, financial security for health care expenditure is still low. This gives patients barriers to choose medical services especially for non-covered medical services, and it becomes narrower. Compared to Korea, Japan has high financial protection in health care utilization, but there exists a limitation using covered and non-covered medical services both together. This is called a prohibition of mixed treatment in health care. This study reviews the Japanese health care system that limits choosing medical services and the burden of health care costs. The prohibition of mixed treatment can alleviate the out-of-pocket burden in the non-benefit sector, but it can be found that it has a huge limitation in that it places restrictions on choices for both healthcare professionals and patients.

• 지역사회간호학회지
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• 제15권3호
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• pp.365-375
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• 2004

Purpose: This study intends to make a database for hypertensive patients and middle-aged women who are visiting the Yeojoo County Health Center. While building up the database, the study reviewed the current assessment tools used in the health center, developed appropriate health care programs, and designed a computerized health care system. Method: The modeling of a database for the system was constructed by MS-Access for DBMS (Database Management System) and Visual Basic. The system is to be used only in the health center by being designed as a client server method, making it possible for many public employees to be interconnected, and enables them to retrieve and search data from the database simultaneously. Results: The health management system systematically follows nursing processes including assessment, diagnosis, intervention and evaluation. Diagnosis. once it is done according to the self determined criteria, saves time and provides appropriate health information for the members. Also, the health education program was developed to follow up on the health status of the members on a continuous basis. Conclusion: Based on these results, it is required to evaluate health care programs provided for the members by using the database system and to develop more practical health care programs. It is also necessary to connect the system to other databases. which contain information about members.

• 대한간호학회지
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• 제25권3호
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• pp.472-484
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• 1995

The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven com-munity health practitioners in Yon- Cheon county. Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children; 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satis-faction toward child rearing and parental sup-port, but no significant difference In education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this re-search, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.

• 전기학회논문지
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• 제59권3호
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• pp.657-663
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• 2010

Today, rapid evolution of Internet makes various types of services in ubiquitous environment are intelligent and active. As a result, user's demand on high quality of life increases and health care service based on ubiquitous environment draws a lot of attention. However, user's private information used for health care service is illegally distributed and exposed, causing serious individual and social problems. Therefore, this thesis is intended to suggest a secure health care service to prevent unauthorized third party's access and to protect user's privacy in health care systems. The proposed scheme establishes a session key through communication channel between health care system and user based on explicit mutual authentication and provides secure communication and access control, improving security as one of the leading health care systems.

• 임상간호연구
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• 제17권1호
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• pp.113-122
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• 2011

Purpose: This study was conducted to develop and evaluate an oral care protocol for cancer patients receiving chemotherapy. Methods: The participants in this study were cancer patients in Severance hospital in Seoul. A total of 31 patients were assigned to the experimental group, and 29 patients to the control group. Data were collected from August 1 to October 5, 2010. The protocol included definition and symptom of oral mucositis, self-check method of oral status, prophylactic method of oral mucositis (oral care, eating habits, and gargling) and management of oral mucositis. Oral Assessment Guide (OAG) was used as the measurement tool of oral mucositis in this study, Oral Care Performance Scale was used as the measurement tool of oral care performance status. Data were analyzed with a $x^2-test$ and t-test, and repeated measures ANOVA, using SPSS/WIN 18.0 program. Results: Patients in the experimental group receiving the oral care protocol had a significant difference (t=-2.938, p=.005) in the oral care performance compared to the control group. However, there was no significant difference (F=1.255, p=.274) in the oral mucositis status between two groups. Conclusion: This study showed that the oral care protocol could improve oral care performance status for the patients under chemotherapy.

• 대한예방한의학회지
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• 제9권2호
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• pp.43-58
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• 2005

Internationally, many countries are facing the demand for reshaping health care systems to cope with rapid changing circumstances in health care sector. The recent growth of oriental medicine and complementary and alternative medicine (CAM) in the many countries is, to a large extent, due to the growth of the number of oriental medical doctors and physicians who have taken up alternative therapies alongside conventional medicine. To cope with the changing environments, many countries consider to develop integrative health care which is now used widely in health care sector. In both biomedical and CAM sectors(including oriental medicine), attention appears to have shifted away from separating therapeutic modalities into categories such as biomedical or CAM, towards a focus on merging diverse modalities into a 'new' integrative health system. In Korea, one of peculiar characteristics of health care system is that as health care provider, Hanbang medicine (traditional Korean medicine) and (western) medicine coexist since 19 century. Recently, the government of Korea has given many efforts to enhance the role and function of traditional Korean medicine in health care sector. However, the strategies and measures for integrative health care settings combining traditional Korean medicine and western medicine on health sector have not been developed yet. The research question of this study is In Korea, what are the trends and problems in interface of traditional Korean medical sector and Western medical sector; what are the causes of or associated factors to the problems; how to cope with the problems and how to resolve the causes?; what are the health policy directions and its strategies that the government should take to cope with the future demand and the burden on health care sector? In order to do this, this study explores the current situations and issues on the interface between traditional Korean medicine and (western) medicine in various ways using contents analysis of existing data and documents related to traditional Korean medicine and health policy. Finally, we discussed stakeholders' views on the interface in the health care sector. Then, health policy options to have shifted away from separating therapeutic modalities into categories such as 'traditional Korean medicine' or 'western medicine', towards a focus on merging diverse modalities into a 'new' integrative health system.

• 대한간호학회지
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• 제11권2호
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• pp.5-8
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• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.