• Asian Pacific Journal of Cancer Prevention
• /
• 제16권16호
• /
• pp.6941-6945
• /
• 2015

Background: Awareness and attitudes of nurses regarding end of life care are important factors in providing hospice care. In an extensive literature review, we found no related articles investigating Iranian nurses awareness and attitudes about providing such care. Objectives: The aims of this study were to investigate the awareness and attitudes of Iranian nurses in providing hospice care. Materials and Methods: In this descriptive-correlational study, 240 nurses employed in six educational centers were selected by non-randomized stratified sampling. The data collection instruments included an awareness test and attitudes regarding providing end of life care in hospice questionnaire. The data were analyzed using descriptive statistics and independent sample t-tests, one-way ANOVA, and Pearson correlation tests. Results: The nurses' awareness score was 14.3 out of 29 and 55.7% of them stated that they had not received any education in providing end of life care. Also, by obtaining the score of 91.7 out of 120 the attitudes of participants in providing end of life care in hospices were positive. In addition, the highest attitudes score of nurses were in the dimensions of benefits of implementation and health care team. Conclusions: Considering low awareness of nurses about end of life care in hospices, continuing education should be provided for them in this regard. Especially, by considering the positive attitude of nurses, providing such programs could help develop hospice care in Iran.

• Tuberculosis and Respiratory Diseases
• /
• 제76권4호
• /
• pp.175-178
• /
• 2014

Here, we report a case of pleural paragonimiasis that was confused with tuberculous pleurisy. A 38-year-old man complained of a mild febrile sensation and pleuritic chest pain. Radiologic findings showed right pleural effusion with pleural thickening and subpleural consolidation. Adenosine deaminase (ADA) activity in the pleural effusion was elevated (85.3 IU/L), whereas other examinations for tuberculosis were negative. At this time, the patient started empirical anti-tuberculous treatment. Despite 2 months of treatment, the pleural effusion persisted, and video-assisted thoracoscopic surgery was performed. Finally, the patient was diagnosed with pleural paragonimiasis based on the pathologic findings of chronic granulomatous inflammation containing Paragonimus eggs. This case suggested that pleural paragonimiasis should be considered when pleural effusion and elevated ADA levels are observed.

• 보건행정학회지
• /
• 제11권4호
• /
• pp.1-20
• /
• 2001

Korean government had introduced copayment system as cost sharing to office-based medical care in order to reduce the demand for care in 1986. This review focuses on trends and characteristics of copayment on office-based medical care from 1991 to the end of Jan. 2001. Objectives of this study is ${\circled}1$ to analyse historical trends of copayment on office-based medical care during the last decade, ${\circled}2$ to analyse the effect of copayment introduced to office-based medical care on NHI finance, ${\circled}3$ to analyse the changing trends of the size of copayment in utilizing office-based medical care for the past 10 years, ${\circled}4$ to evaluate the meaning of copayment alteration implemented after the introduction of new prescription system and finally ${\circled}5$ to draw a some policy implications from the results of this review. We found that the main purpose of copayment introduction had been reduction in the expenditure of NHI finance. But, the reduction effect of insurer's expenditure has turned out to be negative and NHI finance has been in crisis after the introduction of new prescription system. Also, the copayment level of the insured has increased actually on a large scale. It seems that the introduction of new prescription system has changed the meanings and its policy implications of copayment system.

• Journal of Acupuncture Research
• /
• 제33권4호
• /
• pp.109-119
• /
• 2016

Objectives : The aim of this study is to give a statistical basis for the characteristics of patients who received cooperative medical care after being referred from Western medical departments to the Department of Acupuncture and Moxibustion in a Korean medical hospital. Methods : The request records were searched for cooperative medical treatment at the Department of Acupuncture and Moxibustion in a Korean medical hospital between September 1st, 2011 and August 31, 2016, based on the Order Communication system(OCS). The records were reviewed and retrospectively analyzed according to the patient's general characteristics, the chief diagnosis code based on the 7th Korean standard classification of diseases(KCD-7) before and after the cooperative medical care in the Department of Acupuncture and Moxibustion, and the actual treatment measures which patients received as a result of the cooperative medical care. Results : Among the 2702 records, 1549 patients were included in the analysis. The male to female ratio was 1 : 1.17. Sexagenarians formed the highest age group and the number of patients whose age was over 50 was 1176(75.92 %). The surgery department requested the cooperative care from the department of Acupuncture and Moxibustion for the highest number of patients, 1194(77.08 %). When analysing specific medical departments, Neurosurgery, General Surgery, Neurology, Otorhinolaryngology, and Physical medicine and rehabilitation followed. The frequency of chief diagnosis code used before the cooperative medical care was in the order of I, C, G, S, and M code, from highest to lowest. The order of the codes after the cooperative medical care was the same. Acupuncture treatment was the most frequently-used measure after the cooperative medical care. Following were infrared, moxibustion, transfer, herbal acupuncture, cupping, electroacupuncture, and so on. Conclusion : This study provides a statistical basis for the demands placed on the Department of Acupunture and Moxibustion for cooperative medical care with the Western medical department. Based on the present condition of cooperative medical care, more preparation and effort is required for its activation.

• Journal of Preventive Medicine and Public Health
• /
• 제22권1호
• /
• pp.136-145
• /
• 1989

This study made a descriptive analysis of the cumulative amount and rate of sports medical care utilization during the 24th Seoul Olympic Games by the participating athletes, officials, etc. The sports medical care utilization was a component of the total medical care use and was basically caused by the prevention and treatment of sports injuries. The analytic data were derived from the Olympic Health Management Information System(OHMIS) of the SLOOC and the Korea Athlete Trainer Association(KATA). These were analyzed according to the quantity of physician visits and the utilization rate, which was the amount of utilization divided by the total number of participating persons. The results were as follows: Firstly, the sports medical care utilization by the persons participating in the Seoul Olympics amounted to 17.9% of the total medical care utilization. The venue medical services utilization accounted for 54.7% of the total physician visits, which was larger than the village medical center's utilization. The number of physician visits per hundred persons during the 2 week period in the venue clinic was 3.03 and that of the village medical center was 2.51, therefore, the total was 5.54. Secondly, athletes accounted for 82.3% and officials 12.2% in the sports medical care utilization by participants. These results were because athletes, who were directly related to the games, called extremely often on the physicians. The utilization rate of sports medical care by athletes was 34.29. Thirdly, the sports medical demand according to type of therapy could be ranked from high to low in the following order: sports massage, thermal therapy, and electrical stimulation treatment, etc. The department of physical therapy in the village medical center was used a great deal. Fourthly, the trend of daily sports medical care utilization by the athletes showed a bell shape centering around the opening day of the Seoul Olympic Games. The utilization rate of athletes was 2.3; however, that of officials was 0.6. Lastly, the sports medical demand was calculated according to the continents, and Central America, Africa and Middle-East Asia proved to have a higher rate of sports medical care utilization than the more powerful and industrialized continent or regions.

• 한국응급구조학회지
• /
• 제18권3호
• /
• pp.19-35
• /
• 2014

Purpose: This study aimed to improve the quality of prehospital emergency care for elderly patients by determining current prehospital care status based on run sheets and level of knowledge, and prehospital care confidence toward the elderly through questionnaires answered by 119 emergency medical technicians (EMTs). Methods: This study was conducted with 4,946 elderly patients who were transferred to the hospital by 119 ambulances in D city from March 1, 2013 to February 28, 2014. This study was a descriptive study of 119 run sheets. The questionnaire was completed by 160 EMTs working in D city. All data were analyzed by using SPSS 21.0. Results: 74.2% was due to disease among the 4,946 elderly patients who were transferred by 119 ambulances, and a rest was due to injury. The mean knowledge score of the 119 EMTs regarding elderly patients was low. Their confidence on prehospital care of the elderly patients statistically significantly differed according to career at hospital and education. Conclusion: Theoretical knowledge, education on prehospital care of the elderly, and repeated technical prehospital care education and training accompanied by feedback assessment by 119 EMTs are needed.

• Tuberculosis and Respiratory Diseases
• /
• 제72권5호
• /
• pp.452-456
• /
• 2012

Disseminated Mycobacterium avium complex (MAC) infection can occur in immunocompromised patients, and rarely in immunocompetent subjects. Due to the extensive distribution of the disease, clinical presentation of disseminated MAC may mimic malignancies, and thorough examinations are required in order to make accurate diagnosis. We report a case of disseminated Mycobacterium intracellulare disease in an immunocompetent patient, which involved the lung, lymph nodes, spleen, and multiple bones. F-18 fluorodeoxyglucose positron-emission tomography imaging showed multiple hypermetabolic lesions, which are suggestive of typical hematogenous metastasis. However, there was no evidence of malignancy in serial biopsies, and M. intracellulare was repeatedly cultured from respiratory specimens and bones. Herein, we should know that disseminated infection can occur in the immunocompetent subjects, and it can mimic malignancies.

• 보건행정학회지
• /
• 제9권2호
• /
• pp.139-156
• /
• 1999

Recent changes in the health care environment have directed increasing attention to the number and specialty mix of practicing physicians. A major concern identified in Korean health care system is the serious oversupply of specialists and a relative lack of primary care physicians. Currently only 21% of Korean physicians are primary care physicians(general practitioners and family physicians), and less than 10% of recent medical school graduates are choosing to enter primary care. More primary care physicians are needed to deal with major problems in the current health care system, such as cost and access. The infrastructure that relies on primary care physicians is needed to deliver cost-effective and efficient care. To achieve a better balance of primary care to non-primary care physicians. more medical students need to choose careers in one of the primary care specialties(family medicine. internal medicine and pediatrics). This paper suggests the necessity of reforming the Korean graduate medical education system, that is, establishing the path of training primary care physicians in internal medicine and pediatrics residency training programs.

• 보건교육건강증진학회지
• /
• 제7권2호
• /
• pp.78-88
• /
• 1990

The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.

• 한국중재학회지:중재연구
• /
• 제26권1호
• /
• pp.73-87
• /
• 2016

Activation Plan for International Health Care through the Resolution of Medical Disputes with Foreign Patients. The field of international health care is currently being expanded and developed into the new industrial field of medical tourism through the convergence of medicine - a public sector - and tourism - a private sector. This study examines problems with medical law regarding the prevention of medical disputes that may occur when attracting foreign patients and the resolution of these disputes. It also introduces the current most ideal resolution plan for medical disputes. Advanced measures for the prevention of medical disputes with foreign patients are as follows: First, when conducting international health care, the obligation to explain a medical treatment should be applied at higher standards for foreign patients. Second, all medical treatment procedures, including appointments, treatments, discharge, post-operation consultations, and follow-up treatments of foreign patients should be charted and recorded. A checklist regarding precautions for each procedure along with a response manual for problems should also be established. These regulations can prevent unexpected conflicts in advance when medical disputes occur. If a medical dispute with a foreign patient occurs despite thorough advance prevention, it can be resolved through reconciliation, mediation, and arbitration. The government and the medical field along with its related industries and authorities should put their efforts into developing these priori/posteriori measures for the activation of international medical health care. The laws and technological/human capabilities in medicine should also be improved in order to activate international medical health care.