• 제목/요약/키워드: Korean health care delivery system

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진료의뢰센터 경유환자의 진료비 영향요인에 관한 연구: 소화기내과 환자를 중심으로 (Study on the Medical Cost of Patients Visited by Referral Center: Focusing on the Patient in Gastroenterology)

  • 최영두;이광수;홍상진
    • 보건의료산업학회지
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    • 제6권2호
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    • pp.101-109
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    • 2012
  • This study purposed to analyze the differences of cost, length of stay, and number of visits between patients who referred from clinics to a general hospital and patients who directly visit a general hospital. Study sample included 402 patients (177 patients who were not referred from clinics, 225 patients who referred from clinics) who visited the Dept. of Gastroenterology in a university hospital in Daejeon from January to June in 2007. Cost and patients' information were collected from Hospital Information System and medical record. SPSS v.12.0 was used for the statistical analysis. Multiple regression analysis found that for inpatients, location variables and malignant tumors of digestive organs had a significant influence on cost variable. For outpatients, a referring hospital type and visiting month had significant influences on total cost, and sex and visiting month (February) had significant relationship with number of visit. The study results help to understand the differences of patient care depending on whether they were referred from clinics or not. Hospital managements could use the results for marketing purposes, and it could provide valuable information for increasing the competitiveness of hospital in a given market.

Flexible Thin Layer Battery가 부착된 lontophoretic Gel Patch를 이용한 Vitamin C 유도체의 경피 흡수 증진 (Enhanced Transdermal Delivery of Vitamin C Derivative using lontophoretic Gel Patch with Flexible Thin Layer Battery)

  • 조완구;랑문정;송영숙;임영호;박현우
    • 대한화장품학회지
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    • 제33권1호
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    • pp.23-28
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    • 2007
  • 비타민 C는 강력한 환원제로서 멜라닌 색소의 합성을 저해하는 것으로 알려져 있다. 그러나 일반적인 화장품 제형에서는 낮은 안정성과 경피 흡수의 문제점으로 만족할 만한 효과를 나타내지 못한다. 본 연구에서는 안정성이 개선된 비타민 C의 유도체인 ascorbyl glucoside (AsAG)을 유효성분으로 하여 경피흡수를 증가시키고자 하였다. 본 실험에서는 유연하면서도 박막 형태의 배터리를 장착한 패치 화장품을 제조하고 안정성과 경피흡수성을 평가하였다. 피부에 낮은 전류를 증가하는 이온토포레시스를 활용하여 피부에 적용하는 전류의 세기를 증가시키면 물질의 경피흡수는 증가한다. 그러나 전류의 세기를 증가시키면 피부 부작용이 증가하기 때문에 본 연구에서는 한국인의 피부에 맞는 적절한 전류를 선택하여 피부 부작용을 최소화하였다. 이런 결과들을 바탕으로 유연하면서도 가벼운 박막 배터리를 개발하였으며, 2%의 AsAG을 함유한 이온토포레시스 패치의 안전성, 경피흡수정도, 미백효과 등을 검토한 결과 피부에 가하는 최적의 전류는 1.5 V의 배터리를 사용하여 피부 부작용과 경피흡수를 고려하여 평균 0.1 mA이었다. 또한 패치의 임상실험 결과 유의한 수준의 미백효과를 보였으며 피부 자극도도 통상의 화장품 수준을 나타냈다.

이주초기에 나타나는 결혼 이주여성의 신체변화와 대처 (Physical Changes in and Coping with Marriage by Immigrant Women at an Early Stage of Immigration)

  • 김희자;김현숙;전미양;이효정;박은영
    • Journal of Korean Biological Nursing Science
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    • 제16권3호
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    • pp.201-210
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    • 2014
  • Purpose: To provide an in-depth analysis of the physical changes in and marital experiences of immigrant women in Korea, considering the differences in their cultural backgrounds. Methods: A qualitative research methodology with a phenomenology perspective was used. Data were collected through interviews from four focus groups and through in-depth interviews from five individuals. Data analysis was carried out using Colaizzi's phenomenological analysis method. Results: Twenty-four participants from nine different nations were interviewed. Three phenomenological theme clusters were identified and six sub-themes were derived. These comprise: "emergence of physical changes", "experienced symptom with negative result", and "coping with my body". The derived themes comprise: "struggling for my body to survive", "changed body after pregnancy and delivery", "diagnosed as normal but", "neglected my health", "using familiar care", and "unfamiliar health service system". Conclusion: Immigrant women by marriage in Korea are new subjects of nursing care. Their physical changes and experiences in coping with marriage at an early stage of immigration as described by themselves provide valuable information for nursing professionals. Cultural differences, problems specific to women, and our social conditions regarding minorities and our patriarchal tradition that discriminates against women affect their health problems. We strongly recommend that nurses should actively determine and engage in the health problems of immigrant women.

노인맞춤돌봄서비스의 도입 의미와 과제 (The meaning and challenges of the introduction of the Customized Care Services for Older Adults)

  • 전용호
    • 한국노년학
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    • 제40권4호
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    • pp.599-616
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    • 2020
  • 정부는 2020년부터 기존의 6개 노인 돌봄서비스를 일괄 폐지하고, 노인맞춤돌봄서비스를 새롭게 도입했다. 노인돌봄 제도의 큰 변화로 장기요양 등급외자 노인을 위한 예방서비스로서 중요한 역할을 수행하게 되었다. 본 연구의 목적은 노인맞춤돌봄서비스의 도입 의미와 과제를 길버트와 테렐의 정책 분석틀을 활용해서 분석하는데 있다. 연구 결과에 따르면, 노인맞춤돌봄서비스는 사회서비스원의 도입과 커뮤니티 케어를 강조하는 거시 정책 환경에서 탄생한 제도로 노인 돌봄의 할당, 급여, 전달, 재정 측면에서 여러 변화를 초래하는 것으로 분석됐다. 제도적으로 등급외자를 위한 돌봄서비스의 보장성이 하위 70%로 확대되고, 보건의료와 복지의 다양한 급여가 제공될 수 있게 됐다. 또, 전달체계가 지역의 생활권역을 설정해서 수행기관이 전담해서 책임지고, 재정이 공급자 지원 방식으로 바뀌었다. 이를 통해 여러 긍정적인 변화가 기대되지만, 보장성의 여전한 취약성, 셀프케어의 모호함과 직접 대인 서비스의 축소, 서비스권역 설정의 적절성, 공급자 위주 서비스 제공 등의 과제가 발생할 것으로 분석됐다.

Awareness and Perspective on Use and Integration of Traditional and Modern Medicine in a Rural Area of Sokoto State, Nigeria

  • OKAFOR, Henry Chukwuemeka;IKPEAMA, Osita John;OKAFOR, Jane Nkechinyere;OKAFOR, Rita Ifeyinwa
    • 식품보건융합연구
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    • 제7권6호
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    • pp.9-16
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    • 2021
  • There are two forms of medicine that have existed over time and are important in the delivery of expert health care. The forms of medicine are traditional and modern medicine. This study was aimed at assessing the awareness and perspective on the use and integration of traditional and modern medicine in a rural area of Sokoto State, Nigeria. Two hundred and seventy-one (271) respondents were recruited and a self-administered questionnaire on the awareness and perspective on use and integration of traditional and modern medicine was used to assess the participant's view. Among the participants, 200(73.8%) were females. The mean±SD age of respondents was 30.55±9.73 years. 80.8% of the respondents were aware of traditional medicine while 100% were aware of modern medicine. All respondents prefer modern medicine but about 28.8% support integration of both healthcare services. The results were considered significant when p-value was less than 0.005. There is a statistically significant relationship between the integration of traditional and modern forms of medicine and age, gender, religion, education, ethnicity and occupation but not for marital status. Though all the respondents preferred modern medicine to traditional medicine, some people still feel it will be good to combine both for a better healthcare system.

주요일간지(主要日刊紙)의 보건의료관계사설(保健醫療關係社說) 내용분석(內容分析) (An Analysis on Contents of Health-Concerned Editorials in Korean Neswspapers)

  • 김병익
    • Journal of Preventive Medicine and Public Health
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    • 제13권1호
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    • pp.53-66
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    • 1980
  • The editorials of the leading newspapers may reflect as well as help formulate the public opinions to a significant degree. Bearing this in mind, this study was carried out to provide information useful in formulating such public health policies that could practically meet the social interests and demands in health appearing in the editorials of the newspapers. This analysis covered the editorials of 5 leading newspapers such as Donga Ilbo, Chungang Ilbo, Hankook Ilto, Chosun Ilbo and Seoul Shinmoon for about 10 years from Jan. 1st, 1970 through Oct. 31th, 1979. The major findings are as follows: 1. The total number of health-concerned editorials in the five daily papers for the period was 1,768 or occupied 6.4% of the total editorials of the same sources. The increasing trend of frequnecy of the health-concerned editorials since 1976 indicates the increment of social interests and demands in health. Analysing the contents, environmental pollution received the greatest attention in those editorials, which was followed by medical affairs, environmental sanitation, and disease control in order in terms of frequency of appearance. However, there was a tendency that the interests in the environmental pollution, medical affairs and social welfare tended to increase year by year, whereas those in environmental hygiene and disease control comparatively decreased. 2. Motives of dealing with the health-concerned editorials were provided by announcement of the governmental policies and implementation for 25.6% and by out-breaks of the relevant events for 23.9%. This tendency coincides with the general characteristics of the editorials that reflect the timely issues. Closely analysing, however, the fact that the motives engendered by the out-breaks of the relevant events or by the season concerned comparatively tended to decrease as years pass by, indicates that the editorials tend more to seek the future-oriented demands in health rather than the current issue-oriented. 3. The editorials appeared to be more concerned with the governmental policies. 95.7% of all the editorials analysed were addressed to the government. This signifies the role of government in the field of public health and medical affairs. Their attitudes toward health-related policies of the government were much more negative than the other editorials that were addressed to the government in other fields. This suggests that the governmental interests in health were neither sufficient nor fair. 4. What the editorials most stressed were; (1) increment of governmental interests in health, (2) improvement of the governmental health administration, (3) enriching the basic statistics, and (4) development of various technologies pertinent to health affairs and disease control, and so forth. However, must of their suggestions were not concrete but rather abstract and conceptual. 5. The editorials also expressed strong interests in research area. The areas of the needed research most suggested by items are; (1) development of effective health care delivery system, (2) establishment of more practical system of calculating medical cost, (3) implementation of effective policies to control degenerative diseases, (4) division of medical care services and pharmaceutical services systems, (5) effective ways to prevent Co poisoning accidents, (6) changing status of environmental pollution and its effects upon health, and (7) status of occupational diseases, and so forth. 6. There were some editorials -not small in quantity -that have risk to mislead the public opinions as well as the health policies due to lack of professional knowledge of the writers. It is desirable to establish some kind of mechanism that screens the erroneous contents of the editorials to help prevent misleading opinions.

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한국 소아청소년 완화의료의 발전 방안 제언: 국외 제공체계의 시사점을 중심으로 (How to Implement Quality Pediatric Palliative Care Services in South Korea: Lessons from Other Countries)

  • 김초희;김민선;신희영;송인규;문이지
    • Journal of Hospice and Palliative Care
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    • 제22권3호
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    • pp.105-116
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    • 2019
  • 목적: 소아청소년 호스피스 완화의료(이하 소아완화의료)는 생명을 위협하는 질환을 가진 소아청소년의 삶의 질을 향상시기 위한 총체적 돌봄 철학이자 실무의 표준이다. 국내에서는 2018년 7월 국가 지원의 소아완화의료 시범사업을 도입하였는데, 소아완화의료의 발전 방향을 제시하기 위해 국외 선진국의 소아완화의료 제공체계를 고찰하였다. 방법: 소아완화의료 제공 수준을 검토하여 영국, 미국, 일본, 싱가포르를 대상으로 선정하였다. 소아완화의료 제공체계를 다룬 국내외 학술지 등 문헌을 통합적으로 고찰하고 현지 전문가의 자문과 현지 방문조사를 수행하였다. 1990년 이후 영어, 일본어로 발간된 문헌을 중심으로 PubMed, Google, Google Scholar에서 검색하여 학술지, 정책보고서 등을 참고하였다. 각국의 소아완화의료 발전과정, 정책, 재정 모델, 대상 기준, 전달 체계, 질 관리 체계에 대해 분석하였다. 결과: 영국은 지역사회의 독립형 소아전문 완화의료기관이 일차 의료체계와 협력하며 어린이병원의 전문 소아완화의료 자문팀과 의뢰와 자문을 주고받는다. 미국은 병원기반의 전문 소아완화의료 자문팀을 중심으로 지역사회의 호스피스기관, 가정의료기관이 네트워크를 구축하고 돌봄 코디네이터를 지정하여 소아완화의료를 제공한다. 일본은 완화의료, 재택의료, 장애아동 및 만성질환아동 지원체계에서 완화의료 성격의 서비스를 제공한다. 싱가포르는 소아전문 가정 완화의료 단체가 어린이병원의 전문 자문팀과 협력하여 높은 지리적 접근성을 토대로 중추적으로 완화의료를 제공한다. 결론: 국외의 제공체계를 참고하고 국내의 현장의 요구를 반영하여 소아완화의료의 제공체계를 정비하여 미충족 요구가 발생하지 않도록 한국 소아청소년 호스피스완화의료를 최적화해 나가야 한다.

저체중출생아를 위한 가정간호형 모성역할중재 프로그램 개발과 그 효과에 대한 연구 (Development of a Home-based Nursing Intervention, Mothering Program for Low-Birth-Weight Infants)

  • 한경자
    • 가정∙방문간호학회지
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    • 제8권1호
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    • pp.5-24
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    • 2001
  • The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

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농촌지역의 일차보건사업 개발을 위한 기초조사 연구 - 경기도 여주군 금사면 산북부락을 중심으로 - (A Baseline Survey on Development of Primary Health Care in the Rural Korea -Sanpuk Village, Kumsa-Myun, Yuju- Gun, Kyunggi-Do-)

  • 김명호;윤석우;이해숙
    • 농촌의학ㆍ지역보건
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    • 제12권1호
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    • pp.5-27
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    • 1987
  • It is widely recognized that primary health care in the community is one of the most important and effective health measures in these days. However, it is reality that unsatisfactory health care system, ineffective utilization of health care by the community people in the rural area are hampering better understanding for primary health care. Therefore promoting health for the rural people and increasing understanding about primary health care, the baseline survey in the community focused in examination for safe community water supply was carried out. The survey was conducted through August 25-31, 1986 in order to find out health problems and relevant factors and to define the demographic characteristics of $^*$Sanpuk village, Kumsa-Myun, Yuju-Gun, Kyunggi-Do, Korea. Household survey was carried out for every home by trained interviewers. The major results are found out as follows : 1) 84.2%(400 houses) of total households were surveyed because 15.8%(75 houses) were unable to survey due to either refusal against interview or absence of family. These 400 households were composed of 1,697 residents(male:830, female 867). Educational level of respondents showed 34.1% as elementary school graduated. Religion distribution showed Buddism(23.8%) as the most dominant. 50.7% of respondents married in the area. 2) Most households(91.5%) have lived in their own house in Sanpuk area. Average family size showed 4.3. More than half of residents(64.2%) have used public supplied water tap. Only 1.5% of the households had a flush toliet. The rest of households have still used primitive insanitary latrines. 3) 32.5% of residents have used gas burner for cooking and for heating in the house, and the coal briquet were used for boiler. Lack of convenient public transportation was the chief complaint for their day life. 4) Each household occupied 1,990 pyungs of rice paddy and 1,170 pyungs of ordinary field in average. Beside farming products, mushroom was the highest product. 5) Sixth percent of households in the survey area regularly participated in community meeting one hand and on the other hand 39.5% never participated. Most of respondents closely contacted with their neighbours and they seemed very friendly each other. 6) The prevalence rate of illness and injury during recent 15 days showed 48.3 per 1,000. The prevalence rate of chronic illnesses during the past one year showed 74 per 1,000. Injury and accident lead the higher portion(22.0%) in the former and in the latter pain(arthritis, back-pain) showed 27.0% as the dominant sickness. 87.8% of the ill residents in the former received medical treatment. As the most frequently utilized medical facility, the clinic or hospital were counted. Among the residents suffering from chronic illnesses, 77.3% in Sanpuk area get some kind of medical treatments and they rarely utilized the clinic or hospital. The reason why the patient did not receive any medical care was found out the fact that symptoms of illness was light or mild and economic problems was serious. 7) Average age of marriage showed 21.6 years old in the women and the average duration of marital period was shown for 15.1 years. The married woman in reproductive age in Sanpuk area had experienced pregnancies 4 times in the aver-age including 0.7 time of pregnancy in average were interrupted by induced abortion and 0.3 time by spontaneous abortion respectively. The practicing rate of the family planning of the married woman during reproductive ages showed 70.7% and the tuballigation was found out as the most frequently used contraceptives. 8) Among woman who has children under 2 years old, 70.0% had received the prenatal care for the last pregnancy. However, the average number of prenatal care visitis per woman showed 3.3 times. Fifty-two % of woman who received the postnatal care for the last delivery showed only 37.5%. 9) Immunization rate of the children under 2 years old showed relatively high and looked successful. The breast feeding for these children showed dominantly in the most. Most of the mothers in Sanpuk area had started the supplementary diet during weaning period of their infants of 6th and 7th month after birth. * : Sanpuk area is a demstration area for community development which has been supported by the Community Development Foundation during the part 10 years. The village is relatively closer to urban area such as Seoul, However, it has a similar characteristics shown as a remote village because of geographical location and inconvenient transportation at present.

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간호사가 인식하는 간호본질에 대한 탐색적 연구 - 환자중심 병원서비스 전략구축을 위한 기초단계 (An Study on the Nature of Nursing as Perceived by Clinical Nurses)

  • 서문자;김혜숙;김금순;임난영;김귀분;성옥희;주혜주
    • 대한간호
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    • 제35권1호
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    • pp.66-80
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    • 1996
  • Reacently one the main issues has been to develop useful strategies to improve hospital services for patients in the health care delivery system in our rapidly changing society. This study has focused on exploring the perceptions that the clinical nurses have concerning who they are and what they are going to become in the days ahead as medical care reaches a new stage of advancement centered around the patient and hospital services. This study in also based upon the premise that the role of the clinical nurse practitioner. is central to the progress of any patient centered nursing program. This study was carried out by the members of the academic committee of Seoul Branch of Korean Nurses Association from January 1995 to February 1995. The interview method was a semi-structured questionnaire used to collect data from 25 staff nurses who were working more than 3 years at 3 different university hospitals in Seoul. The 6 interviews were selected from each hospital and they were trained for the interviewing techniques. The data were analysed qualitatively and 10 elements of the nurse's responsibilities classified such as caring for the patients (which includes specific medical care as well as general); assessing; diagnosing; coordinating with other health personnel; careful listening; teaching and the patient guiding; administering the prescriptions; giving information and counseling the patient; ward management. Although the premise of this study was based on a wholistic concept, the overall behavioral aspects of hospital clinical nursing were the major thrust of the questionnaire. Broad philosophical questions regarding the nature of nursing need to be further explored. The data gathered for this questionnaire should be useful as a reenforcement tool in educating nursing students as well as in continuing education for clinical nurses. For the future, another study should be done to determine the nursing/patient relationship.

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