• 의료법학
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• 제8권1호
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• pp.215-234
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• 2007

The mission of the doctors is to take care of human life, body and health through the medical behaviors such as diagnosis and treatment. Under this job propensity, the doctors have care duty to take the best actions required to prevent the risk according to the patients' specific disease status. Such care duty of the doctor may be evaluated based on the medical behavior level at the medical institution and clinical medical study field. Such medical level should be understood in the normative level, considering the treatment environment, condition and specialty of the behavior, because it means the medical common sense known and acknowledged to the normal doctors. While the criminal suit requires the evidence for no doubt conviction, the civil suit requires more eased different standard. The results between the criminal and civil sentence may be different, because the confirmed former case may lead to long-term imprisonment and even death penalty, while the latter case puts only monetary penalty on the defeated party.

• 대한건축학회논문집:계획계
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• 제34권5호
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• pp.51-60
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• 2018

The purpose of this study is to find ways to improve the quality of life in old age. 'Act on Long-Term Care Insurance for the Aged' has been enforced since 2008 in Korea. But This is not encompass all of the elderly policies. Aging policies service separately each part by residential, welfare, and so on. There are 'Local Community Support Service' and 'Community General Support Center' for seniors as a comprehensive institution in Japan. Local Community Support Service is preventive and regional. And Community General Support Centers are sufficiently provide for each region. Japan can be a leading model of Korea. Therefor it analyzes Japanese cases and compares to the domestic situations in this study. Through this process, this study measures the necessity of the General Support Center for the elderly.

• 융합정보논문지
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• 제12권5호
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• pp.150-158
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• 2022

본 연구의 목적은 이용자의 관점에서 노인장기요양보험 방문요양서비스 기관 평가의 효과성을 확인하는 것이다. 이를 위해, 전라북도 내 지역별(14개 시·군) 할당표집을 통해 수집한 이용자(266명) 설문자료와 기관(47개) 자료를 결합하여 다층모형으로 분석하였다. 주요 연구결과는 다음과 같다. 첫째, 5개 평가영역 중 이용자에게 권리의식을 갖게하고, 이용자를 존중하는지에 대한 '권리·책임' 영역의 점수가 높을수록 서비스 품질과 만족도도 높게 나타났다. 둘째, 5개 평가영역 중 '권리·책임' 영역과 '급여제공결과' 영역이 충성도에 영향을 미치는 것으로 나타났다. 셋째, '기관운영', '환경·안전', '급여제공과정' 영역은 서비스 품질, 만족도, 충성도에 영향을 미치지 않는 것으로 나타났다. 이러한 결과를 바탕으로 형식적이고 정량적인 평가지표보다는 이용자가 인식할 수 있고, 방문요양서비스의 기본 목적에 충실한 내용으로 평가지표를 재구성할 것 등을 제안하였다.

• 한국산학기술학회논문지
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• 제21권12호
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• pp.651-659
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• 2020

일 공공기관 S보훈병원과 상호 연계된 협진체제를 구축하여 운영하고 있는 V요양병원 환자들의 특성 및 사망위험요인을 파악하여, 양질의 의료서비스를 제공하는 것을 목적으로 한다. V요양병원에서 2017년 1년 동안 850명의 퇴원 환자를 대상으로 2020년 3월1일부터 5월31일까지 3개월 동안 추적조사를 하였다. 조사분석 결과 V요양병원 입원환자는 최저 37세에서 최고 100세로 평균연령은 79.2세, 70세 이상이 86.4%로서 타 선행연구보다 연령 비중이 높았다. 국가유공자가 75.4%로서 유가족이나 일반인 환자보다 3배 이상 높았다. 주진단명은 치매 질환이 22.2%로 가장 많았으며, 심혈관질환, 마비증후군 순이였다. 평균재원일수는 160일이였으며, 재원일수 180일 이상이 46.4%로서 일반 요양병원의 37% 보다 높은 것으로 나타났다. 남성 사망률이 여성보다 높고, 국가유공자는 사망이 생존보다 높은 것으로 나타났다. 사망위험요인은 연령과 재원일수 이었다. S보훈병원으로 전원이 높은 것은 응급센터/재활센터/심혈관센터 등의 진료 이용이 신속하고, 다양한 회복치료가 가능하기 때문이다. V요양병원 중증 만성질환자들에게 S보훈병원으로의 전원은 진료이용이 신속하고 다양한 회복치료의 효과가 높으므로 협진체계를 확대 운영하여 요양병원 만성질환자들에게 건강 회복을 통한 행복한 삶의 질을 높여야 할 것을 시사한다.

• 한국병원경영학회지
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• 제4권1호
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• pp.1-20
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• 1999

Since the late 1980s, there have been radical changes in the managerial environment of Y University Medical Center(YUMC). Externally, the competition among hospitals has intensified due to the establishment of universal health insurance in 1939 and the entrance of large enterprises into the health care industry in the early 1990s. In addition, government regulation of medical institution is becoming stricter. Also, consumer groups have continued to demand the respect for patient rights and improvement of the quality of medical services. Internally, the financial condition of YUMC has worsened, not only because weak control and poor mediation in its large-scale structure have made its operation inefficient, but also because the rates of increase in the prices of goods and labor have grown faster than any increases in revenues. This study on materials management at YUMC presents a way for YUMC to reduce costs and increase its productivity, thereby overcoming its financial difficulties and dealing with external pressures. This study utilized the case studies of the materials purchasing and medical supply management in the United States and the comparative analysis of management to suggest short-term and long-term alternatives for innovation in YUMC. The goals of the short-term alternatives for innovation are to centralize the purchasing and supply departments and to simplify the decision-making processes. Through these attempts, it is estimated that YUMC's costs could be reduced by $600,000 per year. In the long-term, it is necessary to consider introducing a Supply Processing Distribution(SPD) system and setting up a centralized electronic system for supply and inventory management, although it is difficult to estimate the effect of cost-cutting because of the lack of analysis data. Thus, YUMC should thoroughly analyze initial investment costs and economical efficiency generated from long-term alternatives.

• 보건행정학회지
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• 제31권4호
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• pp.451-461
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• 2021

Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.

• 지역사회간호학회지
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• 제27권1호
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• pp.1-8
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• 2016

Purpose: The purpose of this study was to examine the depression and cognitive function of community-dwelling older adults. Methods: 243 aged over 65 in Won-Ju in South Korea participated in this study. Data were collected from April to June 2013 through interviews. This study utilized the Geriatric Depression Scale Short Form, the Korean version of MMSE-DS (MMSE for Dementia Screening), and infirmity testing for basic health status. Descriptive statistics, ${\chi}^2$, t-test, ANOVA, $Scheff{\acute{e}}^{\prime}s$ test, and Pearson's correlation coefficient were used. Results: 75.3% of the participants belonged to the depression group, and the prevalence of cognitive impairment was 17.3%. There were significant differences in depression and cognitive function according to gender, educational level, type of insurance, subjective health, frailty, and whether to be a client of home care service. The level of depression was significantly higher and the level of cognitive functions was significantly lower in older adults in home care services than in community-dwelling older adults. Conclusion: This study is meaningful in that it included older adults in home care services to provide information to develop effective prevention programs for improving cognitive functions. The results of this study can be used to develop future community prevention and intervention.

• 한국콘텐츠학회논문지
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• 제11권1호
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• pp.225-235
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• 2011

본 연구는 노인장기요양보험법에 의해 부산지역에서 노인요양과 관련된 기관에서 노인요양 업무를 수행하고 있는 요양보호사 355명을 대상으로 하였다. 분석방법은 소속기관에 따른 요양보호사의 직무스트레스, 스트레스 대처경험과 대처노력, 그리고 직무만족의 차이를 살펴보기 위하여 t-test를 실시하였으며, 소속기관에 따라 요양보호사의 직무만족에 영향을 미치는 요인들을 분석하기 위하여 회귀분석을 실시하였다. 본 연구의 분석 결과를 요약하면 다음과 같다. 첫째, 요양보호사의 직무스트레스는 요양병원 요양보호사가 요양시설 요양보호사 보다 적게 받고 있는 것으로 소속기관에 따라 유의한 차이가 있었으며, 요양보호사의 직무만족도는 요양시설에 요양보호사가 요양병원 요양보호사보다 높은 것으로 소속기관에 따라 유의한 차이가 있었다. 둘째, 요양보호사의 스트레스 대처경험과 대처노력은 소속기관에 따라 유의한 차이가 있었다. 셋째, 요양보호사의 직무만족 영향요인은, 요양병원 요양보호사의 경우 고용형태 업무 스트레스 환자와의 스트레스 요인이었으며, 요양시설 요양보호사의 경우는 평균임금 고용형태 관리환자 수 업무 스트레스 근무조건 스트레스 환자와의 스트레스이었다. 그러나 소속기관 관계없이 공통적인 영향요인은 고용형태가 정규직인 경우, 업무 스트레스가 낮을수록, 환자와의 스트레스가 높을수록 직무만족이 높다는 것이었다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제4권7호
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• pp.9-18
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• 1998

Even though the interest to the mental hospital is recently increased, the mental hospitals are not well developed due to the pending arrangement of the concept of returning to the society and the system of local communities. Also, the hospitalism due to the isolation of patients and the long term stay in hospitals has become an issue. Despite the present circumstances, the prototype of mental health care in many field are investigated and progressively fixed. This study attempts to examine the current status of domestic and foreign mental institution and to establish the design guideline of the wards of the mental hospitals.

• 대한간호학회지
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• 제7권1호
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• pp.55-62
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• 1977

Varieties of literatures were reviewed in regard to the fundamental concept of day hospital, historical trends, the recipient of its care, facilities and personnel, therapeutic programmes and the follow-up care plans. Through the research the advantages of day hospital were highlighted in order to provide the reference for those who consider planning such health care institution. Since the introduction of the concept of day hospital and its implementation in 1930, many psychiatric patients world over are treated and cared. Patients with specific health problems ; alcoholism, acute or serious psychiatric disease, tendencies of humidor suicidal attempts, and with serious physical problems were excluded from the general recipient. Day hospital were annexed to the psychiatric hospitals in most in instances ; facilities, personnel, except nursing personnel, were shared. All therapeutic care were planned in daley, weekly programmes, and were focussed on socialization. The follow-up care were provided for those participating post- therapy club activities which were planned and introduced ahead. Many advantages of day-hospital care in contrast to the traditional hospitalization care were found: 1. The abrupt discontinuity of his family and other social role is prevented. 2. Therapeutic progress is faster. 3. Lessened economic burden to the family. 4. Behavioral regression is lessened and the lessened fear of hospitalization. 5. Less injury to the patients, self- respect, through lessened anxiety of hospitalization. 6. Incidents of secondary crisis believed to be existing in long term cases are decreased. 7. Therapeutic care implemented in freer atmosphere, better Patient-personnel relationships are created. 8. Varieties of group activities are Induced which enable faster recovery. 9. Patients could engage himself with social activities including getting job on part-time basis. 10. Rehabilitation of patient could be implemented.