• 제목/요약/키워드: Managed care programs

검색결과 25건 처리시간 0.023초

전남 도서지역 보건진료원 업무환경 개선방안 (Improvement for Work Status of Community Health Practitioners in Island Areas)

  • 김옥
    • 한국농촌간호학회지
    • /
    • 제7권2호
    • /
    • pp.59-66
    • /
    • 2012
  • Purpose: The purpose of this study was to assess the work status of community health practitioners in island areas. Methods: Participants in this study were 59 community health practitioners in primary health care posts located on islands in J Province. Data were collected during December, 2011 and analyzed using SPSS 17.0 program. Results: Characteristics of the majority of community health practitioners in the island areas was that they were over 50 years old, married, and had 10 years job experience, The population under their jurisdiction was less than 200 and they had an average of 6-10 patients/day and worked less than 10 hours/day. Health education and practice were the most common of task, and they had various types of paperwork to complete. They visited senior citizens living alone, managed medications, gathered health data for research, waited for night treatment of emergency patients, carried out health promotion programs, and visited seriously ill patients at home after work hours. Conclusion: Results of the study indicate that in order to improve the role and function of the primary health care posts and to boost morale, the practitioners' opinions should be actively accepted by the community health practitioner association and competent government agencies.

보건소 중심의 방문보건.재가복지 통합시범사업 성과 (Outcome Assessment of a Demonstration Project on Integration of Home Visiting Health Care and Social Welfare Services)

  • 안양희;장세진;최균
    • 한국보건간호학회지
    • /
    • 제20권1호
    • /
    • pp.5-15
    • /
    • 2006
  • Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.

  • PDF

SWOT Analysis and Expert Assessment of the Effectiveness of the Introduction of Healthcare Information Systems in Polyclinics in Aktobe, Kazakhstan

  • Lyudmila, Yermukhanova;Zhanar, Buribayeva;Indira, Abdikadirova;Anar, Tursynbekova;Meruyert, Kurganbekova
    • Journal of Preventive Medicine and Public Health
    • /
    • 제55권6호
    • /
    • pp.539-548
    • /
    • 2022
  • Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.

농촌 지역거주 노인을 대상으로 한 허약관리 프로그램의 효과 (A Frailty Management Program for the Vulnerable Elderly in Rural Areas)

  • 안희옥;진영란
    • 한국농촌간호학회지
    • /
    • 제16권1호
    • /
    • pp.18-28
    • /
    • 2021
  • Purpose: This study attempted to confirm whether the suicide prevention effect could be achieved by managing the frailty of the elderly in rural areas. Methods: This study is a single-group pre-post study design. The frailty management program was applied twice a week for 12 weeks for the vulnerable elderly in the rural area from 16th April to 31st May in 2020. The program consisted of physical exercise, health education on nutrition management and disease control, cognitive training, and protein drink provision. Results: The average age of the participants was 77.1 years, and they lived alone (88.6%). As a result of providing the program, there were positive results such as increase in body strength (pre 12.27: post 13.27) and weight (pre 58.51: post 59.13), and decrease in depression (pre 4.66: post 1.20), and there was no statistically significant change in quality of life, Time Up & Go, and BMI. Conclusion: Frailty should be managed to prevent suicide in the elderly. It is necessary to expand and apply various programs that combine physical functions and emotional interventions such as health education, and exercise to maintain muscle strength.

유방암 생존자의 피로와 디스트레스가 자기효능감에 미치는 영향 (The Effects of Fatigue and Distress on Self-efficacy among Breast Cancer Survivors)

  • 서미혜;임경희
    • 성인간호학회지
    • /
    • 제28권4호
    • /
    • pp.378-387
    • /
    • 2016
  • Purpose: The purpose of this study was to describe the impact of fatigue and distress on self-efficacy among breast cancer survivors and to provide a base for development of nursing intervention strategy to improve self-efficacy. Methods: A descriptive research design was used. The subjects were 158 patients who were either being treated or were receiving follow-up care at a university breast center in D City from May 30 to August 30, 2014. Structured questionnaires, Revised Piper Fatigue Scale, Distress Thermometer, and Self-Efficacy Scale for Self-Management of Breast Cancer were used to measure fatigue, distress, and self-efficacy. Data were analyzed using t-test, ANOVA, Pearson's correlation coefficients, and multiple regressions. Results: The mean scores of fatigue, distress, and self-efficacy were 3.83, 4.31, and 3.77, respectively. There were significant differences among participants in terms of educational background, current treatment methods, perceived health status, economic burden for fatigue and perceived health status for distress. Self-efficacy was impacted by age, educational background, marital status, average monthly income, perceived health status, and medical expenses. Fatigue, age, and the burden on medical expense had the most impact on self-efficacy, accounting for 17% of the variance. Conclusion: Fatigue should be managed to improve self-efficacy of breast cancer survivors. Therefore, nursing programs designed to decrease fatigue may be helpful.

치매노인의 우울과 자살의도 (Depression and Suicidal Ideation in Elders with Dementia)

  • 김종필;현미열
    • 대한간호학회지
    • /
    • 제43권2호
    • /
    • pp.296-303
    • /
    • 2013
  • Purpose: The purpose of this study was to investigate the prevalence of depression and suicidal ideation in elders with dementia and to identify factors influencing their suicidal ideation. Methods: A descriptive and cross-sectional study was conducted from February to March, 2011. The participants were 298 older adults whose MMSE-KC score was 15 to 23. Collected Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. Results: According to the Geriatric Depression Scale (GDS) classification criteria, 86.2% of the elders in this study exhibited depression (GDS=5), and 31.5% manifested severe depression. The mean score of suicidal ideation was 5.70 (range 0-20). The risk factors for suicidal ideation were depression, suicidal attempt experience, present location for care, and activities of daily living. Conclusion: The results of this study can be utilized in the development of suicide prevention programs for older adults with dementia. In particular, depression should be screened and managed to reduce suicidal ideation of older adults with dementia.

지역 EMS의 현장검사 혈당측정기 사용에 대한 실태조사 (Survey of Point-of-Care Testing Devices for Pre-hospital EMS Equipment of Glucometer on Local Area)

  • 김병현;최대해;하경임
    • 농촌의학ㆍ지역보건
    • /
    • 제47권4호
    • /
    • pp.220-228
    • /
    • 2022
  • 119 구급대원들이 사용하는 현장 검사 장비 중 하나인 자가 혈당측정기는 결과 값이 정확해야 환자에게 적절한 처치를 제공할 수 있다. 연구 최초 조사 시점 이후 현재까지도 119 구급대원 현장업무 지침에 현장 검사 장비의 작동 유무, 수량 등을 확인하는 것은 있으나, 장비의 점검에 수량, 작동 여부 등은 있으나 본 연구에서 분석한 정도관리 내용은 없다. 현장검사 장비의 질 관리가 되지 않고 있다는 것은 환자에 대한 부정확한 평가와 이로 인한 불필요한 처치와 과소, 과대처치 또는 환자 상태가 악화될 가능성을 높일 수 있다. 본 연구를 통해, 앞으로 119 구급대원의 혈당측정기를 포함한 모든 현장검사 장비의 사용실태조사가 이루어져야 하고, 119 구급대 현장 업무 지침에 현장 검사 장비 정도관리를 추가하여야 하겠다. 또한, 현장 검사 장비가 관련 지침에 따라서 적절한 질 관리가 이루어져야 하고, 지역에서 관련 업무 전문가나 응급의료지도를 담당하고 있는 지도의사에게 관리되는 것이 합당하겠다.

보육교사의 아토피 피부염 아동 관리 현황과 아토피 피부염에 대한 지식 및 실천 (Current Status in Management of Children with Atopic Dermatitis and Knowledge and Practice of Preschool Teachers)

  • 조인숙;류세앙
    • Child Health Nursing Research
    • /
    • 제19권1호
    • /
    • pp.49-58
    • /
    • 2013
  • 목적 보육교사를 대상으로 보육시설에서 아토피 피부염 아동을 관리하고 있는 현황과 보육교사의 지식수준 및 실천 정도를 확인하고 현재의 관리 현황이 보육교사의 지식과 실천에 어떻게 영향을 주는지 파악하는 데에 있다. 방법 대상자는 G광역시 1개구 소재의 보육시설에서 근무하는 보육교사 107명이다. 인구학적 특성, 아토피 피부염 아동의 관리 현황, 그리고 지식수준과 실천 정도(Park, 2011)로 구성된 설문지를 이용하여 자료를 수집하였고 서술적 분석, 일원분산분석 및 사후검정 그리고 상관관계로 분석하였다. 결과 대상자의 대부분이 아토피 피부염 아동을 지도할 때 단순히 부모의 요구에 따른다고 답했다. 절반이상은 아토피 피부염 아동 지도에 대한 지식 부족으로 어려움을 겪고 있었으며 교육과 관리 지침의 제공을 희망하였다. 지식은 75% 수준이었고, 하위영역 중 증상 및 징후에 대한 지식 점수가 가장 높았고 관리에 대한 지식 점수가 가장 낮았다. 실천은 84.3%정도였고, 4개 하위영역 중 음식 관리점수가 가장 높았고 의복 및 침구 관리점수가 가장 낮았다. 그러나 지식과 실천 사이의 통계적으로 유의한 상관관계는 보여주지 않았다(r=.141, p =.149). 결론 대상자는 아토피 피부염 아동을 지도할 때 부모의 요구에 반응하는 소극적 태도를 보였고 지식과 실천은 충분하지 못한 수준이었다. 그들은 지식부족의 어려움을 호소하면서 지침의 제공과 교육을 원한다는 것을 확인할 수 있었다. 따라서 보육교사의 아토피 피부염에 대한 지식과 구체적 실천 방법을 포함한 교육프로그램의 개발이 필요하며 다양한 방법으로 접근할 수 있는 전략을 수립할 필요가 있다.

병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구 (A Preliminary Study for Expending of Hospital-Based Horne Health Care Coverage - Focused on Accident Inpatients Who has the Workers Compensation Insurance -)

  • 이숙자;이진경;유호신
    • 가정∙방문간호학회지
    • /
    • 제6권
    • /
    • pp.5-18
    • /
    • 1999
  • This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

  • PDF

한국보건사회연구원의 역할 (The Role of Korea Institute for Health and Social Affairs)

  • 조재국
    • 보건행정학회지
    • /
    • 제28권3호
    • /
    • pp.217-221
    • /
    • 2018
  • Korea Institute for Family Planning (KIFP) was established on July 1, 1971 (Law 2270) and Korea Health Development Institute (KHDI) was established on April 19, 1976 (Law 2857). Korea Institute for Population and Health (KIPH) was formed through the merger of KIFP and KHDI (Act 3417) on July 1, 1981. Korea Institute for Health and Social Affairs (KIHASA), the former KIPH, was renamed KIHASA on December 30, 1989 (Law 4181) with its additional function of research in social security. It was transferred on January 29, 1999 to the Office of State Affairs Coordination pursuant to the Law on the Establishment, Operation and Promotion of State-Sponsored Organizations (Law 5733). Annually it conducts approximately 50 short- and long-term research projects to accumulate a wide range of research experience. Also it studies and evaluates the primary issues of national health services, health and medical industries, social insurance, social security, family welfare, and population. it conducts joint research projects and active information exchange programs with related domestic and international organizations through seminars and conferences. It executes specific research and development projects according to the government's requests. it educates and trains people domestically and abroad by disseminating a wide-range of information on health and social affairs. it conducts national household surveys on areas of fertility, health and medical care of the disabled, the elderly, and low-income earners. The mid- and long-term research goals of KIHASA should be established and managed systematically. A new organization such as 'Center for Policy Evaluation' is needed to enhance research abilities and experiences. Able research personnels should be recruited and current researchers should try to develop their abilities.