• 보건행정학회지
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• 제30권1호
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• pp.100-111
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• 2020

Background: Few studies have examined the performance of the public long-term care insurance (LTCI) from the perspective of geographic equity. This study investigated regional variations and associated factors in the supply and utilization of nursing home care within and also between Japan and Korea. Methods: A comparative dataset was developed by extracting data from 2013-2015 LTCI statistics yearbooks and Organization for Economic Cooperation and Development regional statistics, as well as other comparable data in Japan and Korea. The unit of analysis was the prefecture in Japan and the province in Korea. We computed variation indices and conducted regression analyses for regional variations within each country and decomposition analyses to examine the variations between the countries. Results: The overall regional supply and use of nursing home care were higher in Japan, but the regional variations in Korea were larger than in Japan. In both countries, the nursing home supply was negatively associated with the proportion of older people with independent living. Nursing home use was also negatively associated with the supply of hospital beds and home care agencies in Korea; the relationship was the opposite in Japan, however. The country-based differences were more likely to be explained by differences in the distributions of the variables included in the analytical model than country-specific characteristics. Conclusion: Regional-level nursing home supply and use were unequal in both countries, and the contributing factors were not the same. Policy efforts are needed to advance regional equality in long-term care (LTC) and collaboration between health and LTC institutions for frail older people, especially in Korea.

• 대한간호학회지
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• 제47권4호
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• pp.540-550
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• 2017

Purpose: The aim of this study was to identify the effect of Dongchimi juice containing kimchi Lactobacillus as an oral hygiene agent and to compare it with that of chlorhexidine solution (0.12% dilution). Methods: This study employed a pretest-posttest experimental design in which a single group of patients was exposed to two different treatments over a period of time. The study included 32 patients hospitalized at a longterm care hospital in Korea. Data were collected between August 12, 2016 and September 28, 2016. The patients first used chlorhexidine solution as an oral care agent for 1 week. After an interval of 2 weeks, they used Dongchimi juice for 1 week. Each agent was applied 2 times a day depending on the protocol. The oral status of the patients was measured using Beck's Oral Exam Guide (OEG) scores. The number of pathogens in the oral cavity was counted by culture, and the patients' subjective satisfaction score for each oral agent was measured using a visual analogue scale. T-test and Mann-Whitney test were performed to identify significant differences between Dongchimi juice and chlorhexidine solution by using PASW Statistics for Windows, Version 18.0 (SPSS Inc., Chicago, IL, USA). Results: The OEG score was not statistically different with the use of chlorhexidine solution and Dongchimi juice. However, decreasing number of pathogens and the subjective satisfaction score were higher with Dongchimi juice than with the chlorhexidine solution. Conclusion: These findings support the use of Dongchimi juice containing kimchi Lactobacillus as an oral hygiene agent for Korean patients.

• 한국병원경영학회지
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• 제7권1호
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• pp.105-120
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• 2002

In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

• 벤처혁신연구
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• 제4권1호
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• pp.39-50
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• 2021

본 연구는 요양병원 직원의 감정노동, 회복탄력성 및 근무환경이 업무성과에 미치는 영향을 확인하기 위한 실증적 연구이다. 경기도에 소재한 200병상 이상 요양병원 직원들을 대상으로 하였으며 회수된 설문지 중 180부가 최종 사용되었다. 수집된 자료는 SPSS 19 를 사용하여 분석하였다. 통계분석은 빈도분석과 기술통계, Pearson correlation 분석과 위계적 회귀 분석을 실시하였다. 연구 결과 일반적 특성 중에는 나이, 결혼유무, 경력, 직위가 업무성과에 영향을 미치는 것으로 확인되었다. 업무성과의 정도는 평균 91.25(±12.46)점, 감정노동은 평균 41.25(±4.21)점, 회복탄력성은 평균 52.89(±6.37)점, 근무환경은 평균 78.93(±15.3)점으로 나타났다. 요양병원 근로자의 업무성과는 감정노동(r=.326, p<.001), 근무환경(r=.384,p=.005), 회복탄력성 .417(p<.001)의 변수 모두와 양의 상관관계를 보였다. 업무성과에 가장 영향을 미치는 요인으로는 근무환경이었으며 두 번째로는 회복탄력성이었다. 회귀모형에 대한 설명력은 48.2%였고 통계적으로 유의하였다(F=58.249, p<.001). 코로나 바이러스의 특수성이 있기는 하지만 이상의 결과에서 요양병원의 업무성과를 향상시키기 위해서는 근무환경을 좀 더 세심하게 개선하고 근로자들이 정신적, 신체적 건강을 유지하도록 도움을 줄 수 있는 프로그램이나 시스템을 구축하는 것이 필요함을 확인하였다.

• 가정∙방문간호학회지
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• 제30권1호
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• pp.69-83
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• 2023

Purpose: This study aimed to present Blue Ocean strategies by deriving the strategic elements of a visiting nursing center and conducting a survey on the importance and satisfaction of care clients. Methods: First, a FGI was conducted targeting the head of the visiting nursing center to derive its strategic elements. Subsequently, importance and satisfaction surveys on the derived strategy elements were analyzed, an IPA matrix was derived, and an as-is ERRC Blue Ocean strategy was established. Kano's Three-Factor Theory was used to derive a competitive position matrix and establish a to-be ERRC Blue Ocean strategy. The Blue Ocean Strategy for Visiting Nursing Center Management is presented in this study. Results: Four as raise factors were derived from combining the results of the as-is, to-be ERRC strategy element analysis: retention of competent nurses, education in medication management, maintenance of high customer satisfaction, and prompt handling of customer complaints. Additionally, the customer's health condition evaluation was derived. Conclusion: Blue Ocean Strategies can be used to analyze, derive, and establish management strategies in various nursing-related entrepreneurship fields.

• 한국병원경영학회지
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• 제13권4호
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• pp.101-118
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• 2008

Japanese national health expenditure was 8.0% of GDP in 2004, and it was lower than average of OECD countries. But it has increased rapidly in recent years. Japan has relatively many acute care beds and high-price medical equipments, and the average length of stay is long. Japanese government is trying healthcare reform to contain healthcare expenditure, increase the efficiency of management and improve the quality of healthcare. As healthcare policies for hospitals such as DPC (Diagnosis Procedure Combination) for acute care beds, reduction of long-term care beds, and functional differentiation and liaison among healthcare institutions are implemented, the number of hospitals in financial difficulties is increasing. The serious situation urges hospitals to adapt to changes and search new directions of management. They need to establish and implement appropriate positioning strategy, and increase management efficiencies. Korean healthcare system has similarities with Japanese in many aspects. The recent reform and changes in Japanese healthcare system and hospitals give suggestions to Korean hospitals as to how they can prepare for environmental changes and improve management.

• Perspectives in Nursing Science
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• 제6권1호
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• pp.55-65
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• 2009

The Korean government introduced Home Care Services System to cut medical cost and make efficient use of limited medical resources because of increasing chronic diseases and the growing population of the elderly. The Korean government established measures to control the use of insurance services by restricting the number of nurse's visits to patient's home and by asking the patients to shoulder the transportation fee of nurses during the visit. Factors such as oversupply of hospital facilities, low price of home care services, high insurance coverage for hospital services and increased nuclear family set up resulted in the limited use of home care nursing services. The introduction of long-term care insurance in 2007 brought the decrease in the number of home care agencies and these agencies are facing a crisis today. The increase in chronic diseases and growing population of the elderly recently resulted in the need to control the high medical cost. Home care services for early discharge patients and chronic-severe disease patients will contribute in the reduction of medical cost at the same time improves the quality of patient's life. To catch up with the demands of the nation, accessibility to home care services should be improved and policies such as the expansion of home care services insurance coverage and promotion of establishing home care agencies should be considered.

• 한국융합학회논문지
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• 제7권3호
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• pp.167-175
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• 2016

본 연구는 요양병원 간호사의 심폐소생술 관련 스트레스, 피로 및 직무만족도와의 관계를 파악하기위한 서술적 조사연구이다. 연구대상은 광주 전남지역에 소재한 요양병원에 근무하는 간호사 220명에 대한 자료를 2014년 11월17일부터 11월30일까지 수집하여 SPSS 20.0 version program을 이용하여 분석하였다. 연구결과 심폐소생술 관련 스트레스 평균은 $3.29{\pm}.64$점, 피로평균은 $3.37{\pm}.56$점, 직무만족도는 $3.06{\pm}.44$점으로 나타났다. 대상자의 일반적 특성에 대한 심폐소생술 관련 스트레스와 피로는 성별, 인력부족에 따라 유의한 차이가 있었으며, 직무만족도는 유의한 차이가 없는 것으로 나타났다. 심폐소생술 관련 스트레스와 피로는 양의 상관관계가 있는 것으로 나타났다. 피로에 영향을 미치는 요인으로는 심폐소생술 관련 스트레스로 27.8%의 설명력을 나타냈다. 따라서 요양병원 간호사의 심폐소생술 관련 스트레스, 피로 및 직무만족도와의 융합적 관련성을 고려하여 스트레스 중재방안 모색, 탄력적인 간호인력 운영, 편안한 병원환경 조성이 요구된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3825-3828
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• 2014

Surgical outcomes of colorectal cancer treatment depend not only on good surgery and tumor biology but also on an optimal perioperative care. The enhanced recovery program (ERP) - a multidisciplinary and multimodal approach, or so called 'fast-track surgery' - has been designed to minimize perioperative and intraoperative stress responses, and to support the recovery of organ function aiming to help patients getting better sooner after surgery. Compared with conventional postoperative care, the enhanced recovery program results in quicker patient recovery, shorter length of hospital stay, faster recovery of gastrointestinal function, and a lower incidence of postoperative complications. Although not firmly established as yet, the enhanced recovery program after surgery could be of oncological benefit in colorectal cancer patients because it can enhance recovery, maintain integrity of the postoperative immune system, increase feasibility of postoperative chemotherapy, and shorten the time interval from surgery to chemotherapy. This commentary summarizes short-term outcomes and potential long-term benefits of enhanced recovery programs in the treatment of colorectal cancer.

• 한국실내디자인학회논문집
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• 제26권4호
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• pp.22-29
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• 2017

This paper investigates the evaluation criteria in order to manage healing environment of long-term care elderly hospital. Elderly hospital evaluation tool developed by Korean Government is used to assess elderly hospital facilities to check the hospital facility and maintain its quality. However, the evaluation indicators and questions mainly focusing on safety indicators. Some questions are too vague for precise evaluation. In this paper, we discuss the advantages and disadvantages of the present evaluation criteria to establish new assessment tool for precise evaluation. The literature research was conducted tp set up the new evaluation criteria. From this research, we developed an elderly focusing on healing environment checklist for elderly care hospital which contains 7 factors as the primary hierarchy structure (Safety, Accessibility, Amenity, Sensibility, Friendly to nature, Territory, Interaction) and 23 factors as the secondary hierarchy structure. This evaluation criteria will help healthcare facility designers and healthcare organizations to build the healthcare facilities.