Background: This study aimed to explore factors associated with the non-use of beneficiaries of long-term care insurance services for the elderly in Jeollanam-do Province by analyzing a dataset obtained from National Health Insurance Service. Methods: The study sample consists of 1,663 individuals who were evaluated as eligible for long-term care insurance services in Jeollanam-do Province during the period of July 1, 2008 through June 30, 2009. As a dependent variable, the non-use of the service was defined as one when a beneficiary had used it once or more times during one year after he or she was evaluated as eligible and as zero otherwise. A proportion analysis was conducted to describe characteristics of study sample. Chi-square tests were used to compare general characteristics between beneficiaries who had used the services and those who had not used them. Multiple logistic regressions were performed by three models including additional sets of explanatory variables such as socio-demographic characteristics, health conditions, and economic status. Results: Main results are summarized as follows. The proportion of beneficiaries who had not used the service was 14.5% of all beneficiaries. According to the results from the model using all explanatory variables, the factors associated with the non-use of the services were residence location, dwelling place, type of desired service, level of care needs, and instrumental activities of daily life limitations. Conclusion: In particular, regarding the type of desired service, the cash benefit showed a high likelihood of the non-use of the service; it had an odds ratio (OR) of 50.212 (95% confidence interval [CI], 24.00-105.04) compared with home service. In case of dwelling place, a hospital showed also a high likelihood of the non-use with an OR of 20.71 (95% CI, 10.12-42.44) compared with home.
Purpose: This study was conducted to identify changes in limb circumferences among patients admitted to the intensive care unit (ICU) and related factors. Methods: We conducted a prospective observational study with 27 patients from 3 ICUs at a university hospital located in B city of Korea, from September 1 to October 30, 2015. The circumferences of the left and right upper arms, thighs, and lower legs were measured on the first, third, fifth, and seventh days of ICU admission. Information on the related factors was collected from the medical records. The data were analyzed using a linear mixed model method. Results: The limbs circumferences significantly reduced from day 3, and the changes continued till day 7. These changes were related to the gender of the subjects, restraints application, use of steroids, and continuous renal replacement therapy. Conclusions: Based on the above results, it can be concluded that ICU-acquired weakness begins before the third day of admission. Thus, early mobilization protocols for ICU patients need to be developed and implemented in order to improve long-term outcomes.
Journal of The Korean Digital Architecture Interior Association
/
v.12
no.2
/
pp.5-13
/
2012
After elderly long term care insurance implementation (July 1, 2008), the elderly medical and welfare facilities covered by medical insurance continuously increases 30 to 63% sanction annually. Rapid growth of senior citizen welfare facilities arises in a poor residential environment issues. In most cases, it is the legal minimum criteria tailored for 4 persons accommodated in nature, such as the hospital. Therefore, 'Hometown-style traditional Korean House' is needed to rest comfortable for elderly people. Research goal is to provide direction and design materials by developing a type of architectural planning for the elderly welfare facilities unit care of the atmosphere of a traditional Korean House. The following two elements are applied to the elderly welfare facilities. Senior citizen welfare facilities in the main living space are applied to modern residential space of the elderly-friendly atmosphere of a traditional Korean House. It is applied for the Korean lifestyle and residential culture are through an analysis of Japan's leading development unit care system.
Journal of The Korea Institute of Healthcare Architecture
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v.22
no.4
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pp.7-17
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2016
Purpose: As our population ages and becomes an elderly society the number of elderly care hospitals is rapidly increasing. Because physical functions and spatial perception in the elderly decrease with age, these hospitals require more systematic and intelligent space designs. The design of these spaces are even more complex because they must accommodate medical programs to treat various different diseases and ailments and also because there are many first time patients and irregular short term patients that seek out outpatient treatment services. Also by analyzing the spatial configuration systems and systematic relationships between each of the functional spaces of the outpatient treatment service departments for hospitals specialized in care for the elderly by focusing on the hallway and corridor systems of these hospitals, the according characteristics and trends were examined. Methods: Based on preceding research, the types of hallway and corridor systems of these hospitals were categorized into five types, including gallery corridors, middle corridors, hall-type, mixed type and cyclic type corridors, and into six types according to function including by medical diagnosis, patient registration, examination, administration and convenience and shared common space to derive any interconnecting relationships between the corridor systems. Also by comprehensively examining the types and combined utilization of the corridor types and the integration and the intelligibility of the space syntax, any trends within the corridor system were derived. The elderly care hospitals examined in this research study were twelve hospitals that opened after the year 2000 in Korea with more that 150 sick beds with areas larger than $1000m^2$ and with all outpatient medical service related rooms located entirely on a single floor of the hospital. Results: The following results could be confirmed based on this research study. 1) The spaces where medical diagnosis and examination occurred were adjacent, and the movement lines for first time patients and re-visiting patients were taken into consideration by separating the treatment space. 2) This research study confirmed that the larger the size of the hospital was, there were more detailed categorizations of treatment services and that there was a tendency for treatment areas to be separated and independent from examination areas. 3) There was a tendency for integration and intelligibility to decrease the more complex and diverse the combination of hall types designed into the corridor systems of these hospitals was. cyclic type corridors dramatically decreased the intelligibility of the corridor systems of these hospitals. 4) The priority rank of these spaces were confirmed to be highest in the order of registration, diagnosis, examination, treatment, administration and shared common spaces. However it was confirmed for the local integration that the diagnosis scope had the highest priority rank. Implications: There were exceptional cases confirmed where the number of unit spaces did not have an absolute effect on integration and intelligibility. These results can be interpreted to mean that this can be overcome through efficient architectural planning.
Institutional care is often necessary for the health and well-being of the elderly. Good quality foodservice provided at long-term care facilities not only includes patients satisfaction but also cares for good health, contributing to the stability of foodservice management. The purpose of this study was to assess the importance and satisfaction attributes of foodservice management by hospitalized elderly patients. The data were collected via questionnaire by a one-to-one interview with 194 hospitalized elderly patients in six different hospitals. According to the results of dependent t-tests, overall mean scores for the importance attributes (3.96) and satisfactory attributes (3.83) were significantly different (p<0.001). As indicated by the patients, the recognized importance attributes were the kindness of foodservice personnel (4.19), kind smiles by foodservice personnel (4.16), and kind speaking by foodservice personnel (4.12). The most recognized satisfaction attributes were kindness of foodservice personnel (4.36), bedside meal service by foodservice personnel (4.25), kind speaking by foodservice personnel (4.24), kind smiles by foodservice personnel (4.24), and sanitary uniforms worn by foodservice personnel (4.21). These results suggest that the above encounter attributes (importance-satisfaction) would be useful tools for hospital foodservices to adopt, in order to control foodservice quality and satisfy the nutritional needs of elderly patients.
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.
The purpose of this study is to investigate the factors that affect the fall prevention awareness of care-givers working at long-term care hospitals. A convenience sampling method was used to select care-givers who worked at 7 different long term care hospitals which were located in D city and N city. Data were collected from July 2014 to August 2014. 200 data were used for analysis out of 215 data which were collected. The hierarchical regression analysis reveals the following results: Firstly, the effects of care-givers' education level, certificate status, period of work experience and fall-related learning hours on their fall prevention awareness level were statistically significant. Secondly, among fall prevention health beliefs, perceived benefit, perceived disability, perceived sensitivity and self-efficacy were positively related to the level of fall prevention awareness. Thirdly, while such factors as perceived benefit, perceived sensitivity and self-efficacy showed positive effects on the fall prevention awareness, the period of work experience had negative effects. The regression model shows the power of explanation of 31.7 percents. In conclusion, the study suggests a fine-tuned program to improve care-givers' fall prevention awareness in a way of promoting fall prevention self-efficacy, perceived benefits and perceived sensitivity while considering the care-givers' period of work experience.
This paper is to suggest policy issues to be done in the future health policy for the elderly, analyzing contents of results suggested in academic papers published in Journal of the Korean Gerontological Society. Number of Papers published in the Journal is 61, occupying most of papers related with chronic disease, medical expenditures and health delivery system except dental and psychiatric health. Method used to be analyzed is mostly random sampling among community inhabitants or hospital patients. Policy issues are as follows in case of being based in the above analysis results. Firstly, it is necessary that the development of health promotion specialized for the elderly be developed and activated. Secondly, it is necessary that the primary health care system specialized for the elderly be constructed. Thirdly, it is necessary that the subacute care system specialized for the elderly be constructed after acute care services. Finally, it is necessary that the health care system specialized for the elderly in need of long-term care be constructed also.
The purpose of this study examine to identify the mediating Organizational citizenship behavior in the relation Authentic leadership and Organizational support. Data were collected by self-report questionnaires targeting 229 caregiver in Daegu city and Gyeongsangbuk-do city. Data were analyzed with SPSS/PC ver. 21.0 programs. There were significantly positive correlations between toward the Organizational citizenship behavior, Authentic leadership and Organizational. As a result of analyzing the main factors the level of care performance for authentic leadership and Organizational support to be significant explanatory variables and this model's explanatory power was 50.0%. Therefore, it is necessary required to improve the Organizational support and leader's authentic leadership for the nursing work performance.
Korea currently has the world's lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%-1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1-2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%-6.6% in Korea. Bilateral blindness was reported in 0.2%-0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%-1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.
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