• Title/Summary/Keyword: Long-term Care Hospitals

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A Study on Dental Health and Chewing ability of Patients Hospitalized in Geriatric Hospital of Daegu (대구소재 한 노인요양병원 입원환자들의 구강상태와 저작능력에 관한 연구)

  • Park, Soo-Chul;Jung, Myung-Hee;Choi, Sung-Mi
    • Journal of Technologic Dentistry
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    • v.33 no.3
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    • pp.237-246
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    • 2011
  • Purpose: This study investigates dental health and chewing ability of patients hospitalized in geriatric hospital, and compares the chewing ability for each factor that can be used as data for dental healthcare of senior citizens and basic data for denture insurance for the elderly. Methods: The 101 subjects of this study were selected from 178 patients hospitalized in a geriatric hospital located in Daegu Metropolitan City, excluding 77 patients who were being treated in the intensive care unit and who were unable to communicate. The chewing ability of the patients were measured using an evaluation scale based on foods consisting of 10 different hardnesses. Results: Patients with less than 21 teeth, those with dentures and patients who were less than satisfied with their dental conditions had difficulties in chewing hard food such as dried squid and radish kimchi, and the Chewing ability increased proportionally to the number of remaining teeth(p<0.001), appropriateness of the maxillary and mandibular dentures(p<0.005) and the level of dental satisfaction(p<0.001). Conclusion: This study is limited as the subjects were selected from a single hospital and the authors estimate that various studies will be necessary to investigate the Chewing ability of patients hospitalized in long-term hospitals. The subjects of this study did not receive any dental treatment while staying in the hospital and many of the subjects had bad fit denture or didn't have dentures or did not use dentures, although they have dentures, which calls for denture construction and prosthetics through dental treatment.

Clinical Prognostic Score for Predicting Disease Remission with Differentiated Thyroid Cancers

  • Somboonporn, Charoonsak;Mangklabruks, Ampica;Thakkinstian, Ammarin;Vatanasapt, Patravoot;Nakaphun, Suwannee
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2805-2810
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    • 2016
  • Background: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. Materials and Methods: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed. Associations between potential clinical prognostic factors and remission were tested by Cox proportional-hazards analysis in 852 patients (development cohort). The prediction score was created by summation of score points weighted from regression coefficients of independent prognostic factors. Risks of disease remission were estimated and the derived score was then validated in the remaining 365 patients (validation cohort). Results: During the median follow-up time of 58 months, 648 (76.1%) patients in the development cohort had disease remission. Five independent prognostic factors were identified with corresponding score points: duration from thyroid surgery to $^{131}I$ treatment (0.721), distant metastasis at initial diagnosis (0.801), postoperative serum thyroglobulin level (0.535), anti-thyroglobulin antibodies positivity (0.546), and adequacy of serum TSH suppression (0.293). The total risk score for each patient was calculated and three categories of remission probability were proposed: ${\leq}1.628$ points (low risk, 83% remission), 1.629-1.816 points (intermediate risk, 87% remission), and ${\geq}1.817$ points (high risk, 93% remission). The concordance (C-index) was 0.761 (95% CI 0.754-0.767). Conclusions: The clinical prognostic scoring model developed to quantify the probability of disease remission can serve as a useful tool in personalized decision making regarding treatment in differentiated thyroid cancer patients.

Factors Associated with Vancomycin-Resistant Enterococcus Colonization in Patients Transferred to Emergency Departments in Korea

  • Kim, Hyun Soon;Kim, Dae Hee;Yoon, Hai-jeon;Lee, Woon Jeong;Woo, Seon Hee;Choi, Seung Pill
    • Journal of Korean Medical Science
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    • v.33 no.48
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    • pp.295.1-295.7
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    • 2018
  • Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

Nursing Activities and Delegation in Long-term Care Settings (요양병원 간호사의 간호행위와 위임실태)

  • Lim, Hee Young;Yun, Mi Jin;Kwon, Young Chae
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.4
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    • pp.191-202
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    • 2019
  • The purpose of this study was to investigate the nursing behavior and delegation status of nursing hospital nurses and to provide basic data for improving the quality of medical services. The subjects of this study were data collected from July 26 to December 23, 2013, for 140 nurses with more than 3 years of experience in nursing hospitals. Collected data were analyzed by frequency analysis, mean and standard deviation, independent t-test and One way ANOVA of SPSS 20.0 statistical program. Collected data were analyzed by frequency analysis, mean and standard deviation, independent t-test and one way ANOVA of SPSS 20.0 statistical program.. As a result of this study, the case of delegation of nursing behavior was higher in case of no protocol of nursing delegation procedure than in case of having protocol. This study suggests that nursing practice of nursing hospital nurses can be a major factor in declining the quality of medical services in the absence of specified standards or procedures for delegation. Procedures, methods and guidelines are required.

A Study on Medical Tourism Evaluation and Institutional Challenges (의료관광 시행 이후에 나타난 성과와 향후의 과제)

  • Moon, Seong-Jea
    • The Korean Society of Law and Medicine
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    • v.11 no.2
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    • pp.275-307
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    • 2010
  • In the presidential new-year address in January 2, 2009, the President declared that 17 kinds of new driving force of growth that could create high-added value be selected to step up job creation and an increase in national wealth. The Ministry of Strategy & Finance announced plans for the 17 kinds of new driving force of growth after the presidential address. Specifically, that ministry announced an ambitious plan to select health care service named 'Global Health Care' as one of the five service industries that could create high-added value in a move to provide jobs to approximately 7,000 people and produce pervasive economic effects coming up to a trillion and 10 billion won. To attain the goal, several action plans were mapped out to globalize domestic medical institutions, to rearrange the relevant law and system for the purposes of raising awareness of domestic medical institutions among foreign patients and improving their accessibility and post-satisfaction level, and to lure lots of foreign patients through financial assistance. At the same time, the government announced plans to lure severe patients such as those in want of surgery or organ transplant, cancer patients or patients with heart diseases to create high-added value on a long-term basis. Thus, the government announced that it planned to formulate such strategies and to enter an agreement with foreign governments to attract plenty of foreign patients. In fact, however, there are little full-scale evaluation of medical tourism though it's been a year since it was introduced, and there are few actual efforts to implement what the government announced, either. According to the results of the evaluation of medical tourism, domestic hospitals are said to undergo little significant changes after the introduction of medical tourism, which shows that they take a dim view of medical tourism instead of having expectations for that. The medical tourism industries in major Asian countries have been dynamized, and there are several factors of their success. First of all, they are successful in creating new market opportunities by incorporating related industries such as medicine, tourism and IT and in developing medical tourism products and differentiated marketing by taking advantage of their competitive edge. They have offered full-fledged assistance to this sector, and another reason is the improved international credibility of their medical service. If our country fails to pinpoint our problems in consideration of the cases of the Asian countries or to provide appropriate financial aid, our country is bound to lag behind them. Given this reality, how to assess medical tourism and what challenges this sector is confronted with are discussed.

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PRESENT STATE AND PROSPECT OF PUBLIC DENTAL HEALTH SERVICE FOR CHILDREN AND ADOLESCENTS IN KOREA (우리나라 어린이와 청소년의 구강건강을 위한 공공서비스의 현황과 전망)

  • Lee, Kwang-Hee;Kim, Jee-Young;Song, Ji-Hyon;Kim, Yun-Hee;Im, Kyeong-Uk;Jeong, Seung-Yeol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.3
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    • pp.578-588
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    • 2008
  • To achieve the dental health of children and adolescents which is the objective of the pediatric dentistry, the role of the public service should be increased. The basis of the public service is established by many laws of which the Dental Health Law is most important. The percentages of primary schools that had the school dental health clinic, that implemented the fluoride rinsing program, and that implemented the group toothbrushing after lunch were 7.2%, 57.5%, and 46.9%, respectively, and the percentages of primary school children that received the dental health education and that received the fissure sealing were 48.0% and 12.4%, respectively(2006). About 42% of infants and preschool children from 0 to 6 years received preventive dental care in the last one year, at the nursery or kindergarten(18%) or at the health center(1%)(2005). The percentage of the health centers that implemented water fluoridation was 11.3%, and the percentage of the population who drank the fluoridated water was 5.7%(2006). It was suggested that the school dental health administration should be unified, that dental health teachers should be employed, and that the comprehensive dental health care should be supplied to all the children and adolescents through the circuit school dentists and the school dental hospitals in the long term. Also, the dentist in charge system for the children and adolescent was suggested.

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Analysis of the Health Insurance Costs of Occupational Therapy in Stroke patients (뇌졸중 환자의 작업치료 보험수가 분석)

  • Kim, Hyun-Jin;Kim, Se-Yun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.1920-1927
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    • 2015
  • This study examined health insurance costs of occupational therapy in stroke patients. The subjects were stroke patients, who underwent occupational therapy by hospitalization or out-patient centers in 2010. The cost of occupational therapy was analyzed from the insurance claims data of Health Insurance Review and Assessment Service in 2010. The kinds of occupational therapy were divided according to the insurance fee of occupational therapy in 2010. In-patients who received occupational therapy paid the highest rehabilitation treatment fee, whereas outpatients paid the highest nervous system function test fee. The cost of occupational therapy in the special rehabilitation treatment fee was highest by 25.3 billion won. The number of uses of general hospitals was the highest by 180 thousand but the total cost of long-term care hospital was highest by 10.4 billion won. The number of uses and cost by regional groups was highest in Seoul and Gyeonggi-do province. This study is meaningful in that a cost analysis of occupational therapy in stroke patients was performed for the first time using the stroke data from the whole country. The result can be used to provide basic data to improve the insurance fee in the future.

Legislative Study on the Mitigation of the Burden of Proof in Hospital Infection Cases - Focusing on the revised Bürgerliches Gesetzbuch - (병원감염 사건에서 증명책임 완화에 관한 입법적 고찰 - 개정 독일민법을 중심으로 -)

  • Yoo, Hyun Jung
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.159-193
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    • 2015
  • Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.

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The Present State and Curriculum Implementation Overview of the Nursing-Specialized Vocational High Schools (특성화고등학교 간호과 운영 현황 및 교육과정 운영실태 분석)

  • Yoon, In-Kyung;Jang, Myung-Hee;Lee, Hyun-Young
    • Journal of vocational education research
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    • v.35 no.4
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    • pp.19-46
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    • 2016
  • The purpose of this study is to analyze the curriculum implementation of the Nursing-Specialized Vocational High School by researching on operation, organization and environment of the program of Nursing. This study aims to improve the curriculum of the Nursing-Specialized Vocational High School. This study has analyzed previous existing studies, Link of School info, Educational Statistics and data indicating establishment, operation and curriculum of the department of Nursing which have been collected from web sites of institutions and associations relevant to Nurse Education. The major results of this study are as follows: 1) As of the first semester of the year 2016, out of a total of thirty eight Specialized Vocational High Schools and Meister High Schools in the country, 6.4% of the schools have nursing educational programs. These schools have established the programs under various names, such as Health Nursing, Dental Health Nursing, Nursing, Nursing and Medical Tourism, Accounting in Nursing and Nursing Management, etc. Since 2012, enrollment rates have increased while post-graduation employment rates have decreased, with the average employment rate of Specialized Vocational High School graduates having reached up to 46% by 2015. 2) The Nursing-Specialized Vocational High School aims to create skilled Nurses Assistant such as Nurse Aide and Care giver. The program is successful in providing necessary courses to acquire required certification and proficient field experience but requires revisional changes in order to create a long-term program of sufficient qualification. The official requirement of 780 hours of field practice was completed during the three educational breaks from the first year of high school to the second year, while the curriculum was conducted separately in the field hospitals. 3) An average of two laboratory classrooms were available based on the facility requirement standard of Cities and Provinces Educational Policies. In order to secure proficient instructors of Nursing education, establishment of specific indicated subjects, regional placement, in-service education, research and supervision are essential for establishing excellence and continual improvement.

Effects of Market Orientation and Relationship Orientation with Suppliers on Business Performance in Animal Clinic Industry: Moderating Effects of Entrepreneur's Characteristics and Clinic Location (동물병원의 시장지향성과 공급업체와의 관계지향성이 동물병원 성과에 미치는 영향: 경영자의 특성과 동물병원 입지에 따른 조절효과)

  • Yoo, Dong-Keun;Suh, Seung-Won;Lee, Yong-Ki
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.2
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    • pp.189-222
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    • 2008
  • This study developed a model to empirically investigate the effects of market orientation and relationship orientation with suppliers on business performance and examine the moderating effects of entrepreneur's characteristics (working tenure) and clinic's location. The data was collected from 200 animal clinics which belong to Korean Animal Hospital Association (KAHA)'s national conference in April, 2007. Descriptive statistic, factor analysis, reliability analysis, and regression analysis were conducted to analyze the data using SPSS/PC+ 12.0. The findings are as follows. First, the market orientation of animal clinics influences significantly both financial and non-financial performance. When the moderating effect of entrepreneur's working tenure is considered, market orientation has significant effect on animal clinic's financial and non-financial performance. However, when the moderating effect of animal clinic's location is considered, market orientation has not significant effect on animal clinic's financial and non-financial performance. Second, animal clinic's relationship orientation with suppliers mostly affects the financial and non-financial performance significantly. When entrepreneur's working tenure in the clinic is longer (above 4 years group), relationship orientation with suppliers significantly affects both financial and non-financial performance. Meanwhile, when the entrepreneur's working tenure in the clinic is shorter (less than 3 years group), relationship orientation with suppliers doesn't affect clinic's financial performance but affect non-financial performance partially. In other words, when entrepreneur's working tenure is shorter (less than 3 years group), market orientation more influences on clinic's financial and non-financial performance while relationship orientation with suppliers does less. It is thought that their relation with suppliers and relationship orientation activities with suppliers are less strongly established and maintained yet. So, they primarily focus on market orientation strategy when entrepreneur's working tenure is shorter. Third, when animal clinics are located in non-metropolitan area, relationship orientation with suppliers significantly affects financial and non-financial performance. However, when animal clinics are located in metropolitan area, it doesn't affect financial and non-financial performance either. It is thought that animal clinics which are located in non-metropolitan area need stronger relationship with suppliers and need support more from them as most of suppliers actively work in metropolitan area not in the non-metropolitan area and animal clinics in metropolitan area can easily get better market information than animal clinics in non-metropolitan area. Lastly, while the effect of the market orientation significantly influences animal clinic's business performance continuously, the effect of the relationship orientation differently influences business performance as it is moderated by entrepreneur's working tenure and animal clinic's location. So, relationship orientation with suppliers can be selectively applied to improve the clinic's financial and no-financial performance. In summary, both of animal clinic's marketing orientation and animal clinic's relationship orientation with suppliers positively influence their business performance. However, entrepreneur's working tenure and animal clinic location moderate the relationship between market orientation and relationship orientation and their business performance differently. This study is quite meaningful to empirically investigate the effects of both of market orientation and relationship orientation with suppliers on business performance and examine the moderating effects of entrepreneur's characteristics (working tenure) and clinic's location. And, as this kind of study has been very few in the context of animal clinic industry, it helps practically understand the effects of market orientation and relationship orientation with suppliers on the financial and non-financial performance in animal clinic industry. Furthermore, as the market conditions in animal clinic industry have been in difficulty for a few years, this study can help improve animal clinic's financial and non-financial business performance together with their suppliers as business partners. Lastly, this study can help find mid-term and long-term cooperation between animal clinics and their suppliers. This study has some limitations. So, care should be taken when generalizing the results of the study. First, our samples were collected from only the animal clinics industry. However, a comparison of the results presented here with those form other marketing contexts (e.g., general hospitals) would be worthwhile. Future comparative research will enhance the generality of our contingency theory cross industry context. Second, this study found that market orientation and relationship orientation affect business performance. However, there may be other antecedents, such as internal market orientation and relationship orientation with customers. Also, this research did not consider other moderators, such as overall market conditions, competitive situations, and power/conflict between suppliers and buyers in the relationship between market and relationship orientation and business performance.

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