• 제목/요약/키워드: Medical Costs

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노인건강문제와 간호의 방향 (Geriatric Health Problems and Directions for Nursing Improvements)

  • 김희자
    • 지역사회간호학회지
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    • 제9권1호
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    • pp.89-103
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    • 1998
  • The elderly population will increase from 5.8% in 1996 to 12.5% in 2020. The related problems of health will also become a very important issue in the future. Therefore it is important to address the problems of geriatric nursing and geriatric health. 87.6% of the aged were ill with chronic degenerative diseases in 1994. In 1995, hospital admission rates (86.8) for those aged 60 or older were higher than that (56.3) of the total age group. Such high medical utilization will increase national health costs. For the development of geriatric nursing, active nursing intervention in various settings combined with education and research should be developed. Considering the health and welfare of the aged and the present status and views in Korea, I suggest the following: First, the health needs of the elderly in the institution, must be met by a plan that fosters geriatric nurses and programmed service development. Second, health service for the residential elderly must be provided in day care centers, short stays, nursing homes and geriatric hospitals. Geriatric nursing services should be provided in home residential areas, public health centers, public health subcenters as well as having, community health practitioners in primary health care posts and home health nurses. Third, geriatric nursing curriculum must be developed adjust to situations and culture of Korea and be included in the nursing curriculum. And gerontological nurse practitioner or geriatric specialist must be fosteraged to provide the professional care for the aged. Geriatric nursing research should be also achived for geriatric nursing improvements.

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모바일 센서 제어 메커니즘을 활용한 휘트니스 추천 시스템에 관한 연구 (A Study on the Fitness Recommendation System Utilizing Mobile Sensor Control Mechanism)

  • 이종원;김동현;박상노;정회경
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2015년도 춘계학술대회
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    • pp.600-602
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    • 2015
  • WHO (World Health Organization)에서 세계적인 전염병이라고 지정한 비만으로 인해 국민 건강과 관련된 사회적 비용이 점차 증가하고 있다. 소득의 향상으로 인해 복지와 Wellbeing 분야에 대한 관심이 증가함에 따라 기존 의료분야의 연구목표가 질병을 치료하는 것에 있다면, 점차 미리 예방하고 관리하는 것으로 변화하고 있다. 본 논문에서는 이러한 사회적 변화를 고려하여 맞춤형 휘트니스 추천 시스템을 제안한다. 이는 사용자별로 어떤 운동 기구를 이용하여 운동을 하는 것이 효율적인지 추천해준다. 이를 위해 모바일 센서가 가지는 하드웨어적 한계점을 소프트웨어적으로 극복하고, 최적화된 센서 제어 메커니즘을 제시한다.

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의약분업이후 대학병원 경영수지변화 비교 분석 (D지역 대학병원 사례를 중심으로) (An Analysis of the Changes in the Financial Performance of Teaching Hospitals after the Implementation of the Separation Policy of Prescription and Drug Dispensing: A case of the teaching hospitals in D area)

  • 은종성;윤경일
    • 한국병원경영학회지
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    • 제8권1호
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    • pp.64-80
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    • 2003
  • The separation policy of prescription and drug dispensing which has been implemented since the 1st of July, 2000, has brought about great changes in patients flow within the healthcare delivery system. The changes in the patients flow, in turn, resulted in the change in the distribution of financial resources among the participating entities in the healthcare delivery system: pharmacies, clinics, small hospitals, general hospitals, and teaching hospitals. The purpose of this study is to shed some light in the change in the financial performance of teaching hospitals under the separation policy that has created environmental changes such as the decrease in the number of out patients visits, the increase in the capital expenditures, the rapid increase in labor costs and so on. For the purpose, this study has compared and analyzed the balance sheets, the income statements and other operational data of three teaching hospitals located in D area. The data include two periods: before(year 1999) and after(year 2001) the implementation of the separation policy. The analysis was conducted with an emphasis on the changes in the financial ratios such as liquidity, turnover ratio, performance ratio. and capitalization ratio. The results show that the financial performances of the hospitals under study were weaker than before the implementation of the separation policy, and that, while the operating expenses have increased remarkably, there was no tendency to corresponding increase in revenue. And the result of analysis of other operational indicators also show that the performance of the hospitals is getting worse. Based on the results, this study has suggested the directions of the healthcare policies. This study suggests to improve the current model of separation of prescription and drug dispensing, to grant subsidies for the training of residents in teaching hospitals, and to lower the rate of patients' out of porket payment in teaching hospitals.

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가구구조 변화가 서비스 수요에 미치는 효과 분석 (The Effects of Changes in Household Structure on Service Consumption in Korea)

  • 황수경
    • KDI Journal of Economic Policy
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    • 제33권3호
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    • pp.57-85
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    • 2011
  • 본 연구는 저출산 고령화의 진전과 여성 경제활동참여 증대 등에 따른 가구구조 변화가 가계생산에 영향을 주어 서비스 수요를 변화시키는 효과를 분석한다. 특히 기존에 가계생산에 의존하던 가사노동 및 돌봄서비스 등을 시장서비스로 대체하는 과정에서 추가적인 서비스 수요가 발생할 수 있음을 이론적 실증적으로 분석하고 있다. 우선 3부문 시간배분모형을 통해 가계생산의 시장화가 서비스산업의 확장을 가져오는 메커니즘을 이론적으로 탐색하였다. 다음으로, 우리나라 가구구조 변화가 각 소비항목별 수요에 미치는 효과를 분석하기 위해 QUAIDS 수요분석모형에 따른 엥겔곡선을 추정하였다. 분석자료로는 "가계동향조사"를 이용하였다. 분석 결과에 따르면, 단신가구의 증가, 유배우가구의 감소, 6세 미만 자녀 가구의 감소와 같은 가구 구성의 변화, 그리고 맞벌이가구의 증가 등은 의료비, 교육훈련비, 가사서비스 등 전형적으로 가계생산서비스를 대체하는 시장서비스에 대한 수요를 증가시키고 있는 것으로 분석되었다.

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Leukocyte- and platelet-rich fibrin as an adjuvant to the surgical approach for osteoradionecrosis: a case report

  • Maluf, Gustavo;Caldas, Rogerio Jardim;Fregnani, Eduardo Rodrigues;da Silva Santos, Paulo Sergio
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권2호
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    • pp.150-154
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    • 2020
  • We present a case of osteoradionecrosis treated with leukocyte- and platelet-rich fibrin (LPRF) and surgery and followed up with clinical and tomographic investigations. A 65-year-old woman presented with pain in the posterior region of the right palate. Her medical history included cardiovascular disease and squamous cell carcinoma in the anterior region of the floor of the mouth that had been treated with intensity-modulated radiation therapy. Measurements of isodose curves showed a full dosage of 6,462.6 cGy in the anterior mandibular region, whereas that in the posterior region on the right side of the maxilla reached 5,708.1 cGy. Osteotomy was performed using rotary instruments, and debridement and placement of two LPRF membranes were also carried out. New gum tissue with no bone exposure was noted 14 days postoperatively. Tissue repair was complete, and the patient had no further complaints. During a 39-month follow-up period, the oral mucosa remained intact, and the patient was rehabilitated with a new upper denture. Since there is no consensus regarding the best protocol to treat osteoradionecrosis, LPRF might be an interesting adjuvant to a surgical approach. The use of LPRF is simple and reduces operational costs, time of handling, probability of technical failure, and associated morbidities for patients with osteoradionecrosis.

다문화가정 이주여성의 임신과 출산 건강관리 실태 (A Survey on Health Management of during Pregnancy, Childbirth, and the Postpartum of Immigrant Women in a Multi-cultural Family)

  • 정금희;고효정;김계숙;김선희;김진향;박혜숙;이영숙;한영란;김경원
    • 여성건강간호학회지
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    • 제15권4호
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    • pp.261-269
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    • 2009
  • Purpose: The purpose of this study was to investigate health management state during pregnancy, childbirth, and postpartum of immigrant women. Methods: A descriptive research design was employed. Data were collected from 182 immigrant women who lived in four provinces and D city. Subjects were completed the following questionnaires: demographic, medical service use, pregnancy and childbirth, and health management during the ante-postpartum. Results: The average age of subjects was 28.96 and 83 subjects (45.6%) were coming from Vietnam. 55 Subjects (30.2%) were within the low-income group with less than 4 million won per month. So, 62 subjects were uninsured women because of the expensive costs. Subjects mainly visited a health care center with their husband. On the using a health care center, subjects complained about communication difficulties and transportation problems. 42 Subjects were pregnant but 21.4% of pregnant subjects did not receive ante-natal care. Subjects got information about pregnancy and childbirth through their husbands and husband's family. Conclusion: Nursing intervention to manage the pregnancy, childbirth, and the postpartum of immigrant women need to be developed and should include strategies to take care of themselves after delivery and provide knowledge and information about ante-postpartum.

2013년 정신건강박람회 불안 장애 선별검사 결과 (Results of Anxiety Disorder Screening Programat the 2013 Mental Health Exposition in Seoul)

  • 최강록;김대호;서호준;허휴정;이동우;채정호
    • 대한불안의학회지
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    • 제9권2호
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    • pp.147-153
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    • 2013
  • Objective : Despite the chronic nature and high social costs, individuals with anxiety disorders seldom seek treatment. Thus, education for public awareness and screening for the illness is tremendously important for mental health professionals. This study summaries and presents the results from Anxiety Disorder Screening Program during the Mental Health Exposition held in Seoul in April, 2013. Methods : We analyzed the data from 116 participants who agreed and completed the screening questionnaires during their visits to two-day Anxiety Disorder Screening Program prepared by the Korean Academy of Anxiety Disorder. The questionnaire comprised of modified Mobility inventory for agoraphobia, Contents of worries, Penn State Worry Questionnaire, Life Events Checklist, and Abbreviated Posttraumatic Stress Disorder Checklist. Results : Participants demonstrated high rates of anxiety symptoms and possible anxiety disorders. Experience of panic attack was reported by 45%, lifetime and 16% in the past month by respondents. Phobia was reported by 46%. Participants had an average of 3.3 pathological worries and among those, social or interpersonal content was most common (46%). At least one lifetime traumatic event was reported by 64%. By the cut-off scores in the literature, 46% had possible generalized anxiety disorder and 58% possible posttraumatic stress disorder. Conclusion : Our results suggested that many visitors to Anxiety Disorder Screening Program were in fact treatment seeking after experiencing some forms of anxiety symptoms. Further efforts for delivery of medical information and increasing public awareness for anxiety disorders are needed.

난청감별을 위한 휴대용 자동 청성반응 검사기의 개발 (Development of a Portable Automatic Auditory Response Tester for Hearing Loss Screening)

  • 김수찬
    • 전자공학회논문지SC
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    • 제49권2호
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    • pp.38-45
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    • 2012
  • 선천성 난청으로 태어난 아이를 조기에 진단하여 가능한 빨리 적절한 치료를 해줌으로써 치료 효과를 극대화하고, 이후에 발생되는 사회적 비용을 최소화할 수 있기 때문에 신생아로부터 난청 이상 유무를 객관적으로 판별하는 검사 장비가 필요하다. 대표적인 것으로 청성뇌간반응(auditory brainstem response, ABR) 검사가 있으나 클릭음(click sound)에 대한 반응으로 주파수 특이성이 없고 고주파수 대역에 대한 청력을 주로 반영하는 단점이 있다. 청성지속반응(auditory steady-state response, ASSR) 검사는 주파수 특이도는 좋으나 오진의 가능성이 조금 높다. 이러한 단점을 보완하여 청성뇌간반응 검사와 청성지속반응 검사를 하나의 시스템에서 측정하고, Fsp와 F-test 분석을 통하여 객관적 지표를 보여주는 시스템을 제안하였다. 하드웨어 구성요소를 최소화하고 소프트웨어 역할을 강화하여 추후 하드웨어 수정 없이 소프트웨어의 수정만으로 다양한 검사가 가능하도록 설계하였다. 제안한 시스템의 객관적 평가 기능은 정상인 10명을 대상으로 한 실험을 통하여 검증하였다.

3D가상 현실방식을 사용한 수술교육시스템의 연구 (Study for Operation Teaching Machine Using 3D Virtual Reality System)

  • 강병훈;김지숙;김한웅
    • 디지털콘텐츠학회 논문지
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    • 제17권4호
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    • pp.287-293
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    • 2016
  • 시간, 공간, 금전적인 문제 때문에 실습이 쉽지 않은 학문들이 있다. 특히 의료교육은 장소와 시간의 제약이 특히 심하며 cadaver(카드버:인체해부 실습용 시체)를 통해 이루어지기 때문에 어려움이 많다. 그 대안으로 다양한 가상 수술방법이 존재하지만 장비가 고가이거나 구하기 쉽지 않기 때문에 어려운 문제가 발생한다. 이러한 문제점의 해결 방법으로 3D-Virtual Reality(3D가상현실)를 활용하여 실제와 유사한 환경을 제공하고자 한다. 일반적으로 컴퓨터의 Interface(인터페이스)로 키보드와 마우스를 사용하지 않고 Oculus Rift(오큘러스 리프트)와 Leap Motion(립 모션)를 사용함으로써 더욱더 현실감을 느낄 수 있어 실습교육비용을 절감함으로써 실습교육에 대한 효과를 극대화 할 수 있다. 본 논문에서는 두개의 Device(디바이스)인 Oculus Rift(오큘러스 리프트)와 Leap Motion(립 모션)를 이용하여 3D가상 수술 시스템을 구축하고 실습할 수 있는 제안으로 의료교육인 수술교육에 대치하여 효율성을 높이는 방식을 제안하였고, 이는, 다른 Simulation(시뮬레이션)이 활용 가능한 학문분야에 까지 확장할 수 있을 것으로 사려된다.

Influence of Payer Source on Treatment and Outcomes in Colorectal Cancer Patients in a University Hospital in Thailand

  • Sermsri, Nattapoom;Boonpipattanapong, Teeranut;Prechawittayakul, Paradee;Sangkhathat, Surasak
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.9015-9019
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    • 2014
  • The study aimed to compare the 2 main types of insurance used by colorectal cancer (CRC) patients in a university hospital in Thailand: universal coverage (UC) and 'Civil Servant Medical Benefit Scheme' (CSMBS) in terms of hospital expenditure and survival outcomes. CRC cases in stages I-IV who were operated on and had completed their adjuvant therapy in Songklanagarind Hospital from 2004 through 2013 were retrospectively reviewed regarding their hospital expenditure, focusing on surgical and chemotherapy costs. Of 1,013 cases analyzed, 524 (51.7%) were in the UC group while 489 (48.3%) belonged to the CSMBS group. Cases with stage IV disease were significantly more frequent in the UC group. Average total treatment expenditure (TTE) was 143,780 Thai Baht (THB) (1 US$ =~ 30 THB). The TTE increased with tumor stage and the chemotherapy cost contributed the most to the TTE increment. TTE in the CSMBS group was significantly higher than in the UC group for stage II-III CRCs. The majority of cases in the UC group (65.5%) used deGramont or Mayo as their first line regimen, and the proportion of cases who started with a capecitabine-based regimen (XELOX or $Xeloda^{(R)}$) was significantly higher in the CSMBS group (61.0% compared to 24.5% in the UC group, p-value < 0.01). On survival analysis, overall survival (OS) and progress free survival in the CSMBS group were significantly better than in the UC group. The 5-year OS in the CSMBS and UC groups were 84.3% and 74.6%, respectively (p-value < 0.01). In conclusion, the study indicates that in Thailand, the type of insurance influences resource utilization, especially the choice of chemotherapy, in CRC cases. This disparity in treatment, in turn, results in a gap in treatment outcomes.