• 제목/요약/키워드: Medical referrals

검색결과 28건 처리시간 0.034초

Predictors of the Utilization of Oral Health Services by Children of Low-income Families in the United States: Beliefs, Cost, or Provider?

  • Kim Young Ok Rhee;Telleen Sharon
    • 대한간호학회지
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    • 제34권8호
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    • pp.1460-1467
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    • 2004
  • Purpose. This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. Methods. In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. Results. The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on week-ends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. Conclusion. The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.

응급실 내원 뇌 손상 환자의 진료과정과 결과 (Treatment Process and Outcomes of Brain Injuried ER Patients)

  • 홍혜련;진기남;이동우;김재수
    • Journal of Preventive Medicine and Public Health
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    • 제31권3호
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    • pp.481-489
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    • 1998
  • Injuries and infectious diseases have been the most important public health problems since the beginning of human life. Injuries result in death of about 30,000 people each year in South Korea. In terms of years of life lost, injuries are considerably more costly than either heart disease or cancer. In terms of cost - both the direct costs of care and the indirect costs to individuals, families, and societies of a diminished life-injuries are among the most expensive of all social problems. The main purposes of this study are (1) to describe the outcomes as well as treatment process of brain injured patients and (2) to identify the factors impacting on length of stay during hospitalization and hospital fees. The research method used in this study was to review the medical records of five hundreds brain injured cases using systemic random sampling. The multiple logistic regression was administered to identify the factors impacting on the outcomes. The results are as follow : (1) the consultation .ate was found to be 72.9% while referral rate was 11.2%; (2) nearly 30% of the respondents were hospitalized over 30 days; (3) multiple logistic regression analyses revealed that the determinants influencing LOS were number of consultations, number of lab tests, and surgery; (4) the determinants of hospital fee were severity of brain injury, gender of patients, number of consultations, number of lab tests, and surgery.

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노인대상 의료기관 가정간호사업의 운영실태 (An Analysis of the Elderly Care and Management in Hospital-Based Home Care Agencies)

  • 송종례;강임옥;김윤옥;조혜숙;황문숙
    • 지역사회간호학회지
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    • 제19권4호
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    • pp.660-672
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    • 2008
  • Purpose: To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly. Method: The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%. Result: The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated. Conclusion: This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.

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3차 병원 통증 클리닉에 의뢰되어 오는 환자들의 특성 분석: 전라북도 지역의 다기관 연구 (An analysis of patients referred to the advanced general hospital pain clinic center: multicenter study in province of Jeollabuk-do, Korea)

  • 김연동;이철형
    • 한국융합학회논문지
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    • 제12권2호
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    • pp.311-316
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    • 2021
  • 통증클리닉에 의뢰되어 오는 환자들의 수는 증가하는 추세에 있다. 본 연구는 3차 병원의 통증클리닉에 의뢰되어 오는 환자들을 분석하여 그 특성을 파악하고자 시행되었다. 2011년 1월부터 2015년 12월까지 전라북도 지역의 3개 대학병원 통증클리닉에 의뢰되어 온 환자 587명을 대상으로 연구를 수행하였다. 데이터는 외래 진료 기록지를 참고하여 후향적으로 수집되었다. 이들 환자를 연령, 성별, 주된 증상, 통증 위치, 동반 질환, 의뢰 부서, 의뢰 원인에 따라 분석하였다. 통증 클리닉에서는 많은 의학적 문제에 봉착하게 된다. 따라서 통증클리닉에서 표준화된 진료지침이 필요하며, 이를 위해서는 환자들의 특성을 파악할 필요가 있다. 더 많은 환자를 대상으로 한 전국단위의 연구가 이루어진다면, 환자들의 특성을 더욱 정확히 파악할 수 있을 것으로 생각된다.

영상정보교류 실태 파악을 위한 의사 설문조사 (Status of Interchange of Medical Imaging in Korea: A Questionnaire Survey of Physicians)

  • 최문형;정승은;김성준;신나영;용환석;우현식;정우경;진광남;최선형
    • 대한영상의학회지
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    • 제79권5호
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    • pp.247-253
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    • 2018
  • 이 연구의 목적은 영상정보교류의 효용성을 높이기 위한 영상 품질 기준 연구에서 영상정보교류의 실태를 파악하고 영상정보교류에 대한 의사들의 의견을 수렴하기 위해 시행한 설문조사의 결과를 정리하는 것이다. 설문조사는 개별 접촉 또는 소셜 네트워크 서비스를 통해 홍보하였고, 자발적으로 참여한 의사가 설문조사의 대상이다. 설문조사는 기본 정보 및 영상정보교류에 대한 11개의 문항으로 구성되었다. 총 30개 진료과의 전문의 160명이 설문조사에 참여하였고, 95.6%의 응답자가 상급종합병원 또는 종합병원에 근무하는 상태였다. 외부 병원에서 영상검사를 시행한 후 의뢰되는 환자가 빈번하였다. 하지만 판독소견서가 함께 교류되는 경우는 드물었고, 의뢰받은 의료기관의 영상의학과 전문의에 의한 재판독을 통해 이차적인 의견을 구하고자 하는 요구가 많았다. 결론적으로, 외부 판독소견서가 누락되는 경우가 많으므로 판독소견서가 영상정보와 함께 교류될 수 있도록 하는 방안의 마련이 필요하다. 또한 외부 판독이 있더라도 재판독이 필요하다는 의견이 많은 점을 고려할 때 판독소견서에 반드시 포함되어야 할 기본적인 판독소견서의 요소 및 외부 검사의 재판독에 대한 가이드라인이 필요할 것으로 생각된다.

정신건강문제 해결자원의 유용성에 관한 신념: 우울증과 정신분열병의 비교 (Koreans' Beliefs on Helpfulness of Mental Health Resources: A Comparison between Depression and Schizophrenia)

  • 서진환;이선혜
    • 보건교육건강증진학회지
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    • 제26권3호
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    • pp.97-110
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    • 2009
  • Objectives: This study investigated Korean public's beliefs on helpfulness of various resources and preferred ways of addressing symptoms of mental health problems. Methods: A household survey was conducted on a stratified sample of adults aged between 18 and 74 (N=1,584). The participants were asked to provide their opinion on helpfulness of 39 resources for problems presented in the vignette, either depression(DEP) or schizophrenia(SPR). Descriptive statistics and factor analysis were conducted to summarize their opinion and to identify the underlying structure of beliefs about helpfulness of various resources. Results: Counselors/psychologists/social workers, family, psychiatrists, other therapists, and religious leaders were believed to be the most helpful. Methods that require one's initiatives marked percentages much higher than those of 'waiting to get better' or 'dealing with it alone'. The percentages for medications were lower than other methods in general, but higher than those of a western sample especially on antidepressants and anti-psychotics. Psycho/social approach was favored more for SPR than for DEP, and popular/cultural approach was favored much more for DEP than for SPR; physical/medical approach was strongly unfavored against DEP. Conclusion: Strategies need to be developed for utilizing various helpful resources to diversify modality of mental health services and facilitate referrals and gatekeeping. The differences in beliefs on helpfulness of various methods between DEP and SPR point to the need for problem-specific strategies.

신설대학병원에서 1년간의 정신과 자문 (Psychiatric Consultation at a Newly Opened University Hospital)

  • 독고향;배재남;강민회
    • 정신신체의학
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    • 제6권1호
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    • pp.46-58
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    • 1998
  • Objectives : This study was performed to evaluate the status of psychiatric consultation at a newly opened university hospital, to explore problems related to psychiatric consultation and to contribute for future consultation to be more systematic and more efficient. Methods: The subjects of this study were 284 patients hospitalized at Inha University Hospital between September 1, 1996 and August 31, 1997, who were referred for psychiatric consultation during hospitalization. This study was evaluated demographical characteristics of referred patients, resons for referral, recommendations by psychiatric consultant, clinical diagnoses, psychiatric diagnoses, relationship between referral time and hospitalization following the day of consultation and consultation referral types based upon psychiatrists' reports and patients' medical charts. Results : Most common patients referred to consultation were females aged 20s who visited at the department of internal medicine and related to the risk of suicidal attempts. Mood disorder was the most frequent psychiatric diagnosis, and the most common recommendations were to use psychopharmacological treatment along with outpatient visits. The 30% of subjects were referred to consultation within a day after hospitalization. In the case of consultation referral timing within two days and after three days, there was significant difference between early consultation and shorter hospitalization following the day of consultation. Most frequent type of consultation(29.6%) was categorized as IIIa type(physical complication type as a "Mending" request type). Conclusion : In review of consultation referral timing and consultation referral type of the subjects, who were referred for psychiatric consultation for one year at a newly opened University Hospital, referrals were found to be made within two days after their admission to hospital(50.7%), which was observed to be early request. We found that there was significant association between early consultation and shorter hospitalization following the day of consultation. The physical complication type(29.6%) which belongs to "Mending" request type was found to be the most frequent consultation referral type. This result indicates that more systematic psychiatric consultation is needed for the future.

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Palliative Care for Adult Patients Undergoing Hemodialysis in Asia: Challenges and Opportunities

  • Wei-Min Chu;Hung-Bin Tsai;Yu-Chi Chen;Kuan-Yu Hung;Shao-Yi Cheng;Cheng-Pei Lin
    • Journal of Hospice and Palliative Care
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    • 제27권1호
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    • pp.1-10
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    • 2024
  • This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.

병원중심 가정간호사업에 대한 의사, 간호사의 인식과 태도에 대한 조사연구 (A Study on the Recognition and Attitude on Home Health Care Program between Physicians and Nurses in a Hospital, Pusan)

  • 김정순;고영희;김대숙;김정화;신재신;이길자;정인숙;황선경
    • 가정∙방문간호학회지
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    • 제8권2호
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    • pp.148-158
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    • 2001
  • Purpose: This study is to investigate the attitudes on the Home Health Care among the physicians and nurses in P University. Method: Data were gathered from 71 physicians and 264 nurses. working at P University Hospital. from May 1 to May 15, 2001 and analyzed using descriptive statistics and Fisher exact test. Results: 1) As to the previous information about home health care program, those who have been familiar to it were 100% of physicians, and 99.6% of nurses, and 39% of the physicians and 66.1% of the nurses. were found to have responded with right answers, 2) As to the acceptance of the home health care program, 87% of physicians and 98.5% of nurses were found to be positive and there showed a significant difference(p= .019), 3) The main reasons for accepting the system were: the alleviation of the family burden of time, the maintenance of continuity of care, and the reasons for opposing the system were incomplete legal assurance. the possibility of providing illegal medical services. 4) The physician's intention rate of patient referrals to home care program reveled 49.2%. 5) According to the services related to Home Health Care. the orders of acceptance rates were medical tests related services (77.8%, 92%); therapeutic nursing interventions(69.0%, 88.2%): and services for medication(68.3%, 82.5%) among physicians and nurses. respectively. Conclusion: For the stabilization and successful implementation of home health care system. it should be accompanied with education for physicians about home care. setting specific laws and regulations for home care. legal assurance of home care business. outcome research for home care recipients. and support systems of hospital administration.

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유럽 각국의 낙태 접근과 여성건강 - 한국 낙태논쟁에 대한 함의 - (Different Abortion Approaches in Europe and Women's Health: Implications for Korean Abortion Debates)

  • 정진주
    • 페미니즘연구
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    • 제10권1호
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    • pp.123-158
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    • 2010
  • 지난 몇 달간 우리 사회에 낙태가 쟁점이 되고 있다. 저출산 문제를 해결하기 위해 낙태단속을 강화해야 한다는 의견이 제기되는 한편, 외국에서는 찾아보기 힘든 산부인과 의사 간의 낙태 논쟁 및 고발이 진행 중이고 여성계와 정부도 이에 대한 대응을 내놓고 있다. 이러한 맥락에서 본 논문의 목적은 낙태의 정책방향을 여성건강의 관점에서 제시하기 위해 유럽의 사례를 고찰하는 데 있다. 낙태의 법적·사회적 수용도 및 안전한 낙태시스템 보장 수준을 기준 삼아 아일랜드, 영국, 네덜란드 세 국가를 선정하여, 개별 국가의 낙태에 관한 국가정책, 법적 기준, 의료 체계, 시민사회 등의 역학이 여성건강에 미치는 영향을 분석하였다. 이들 국가의 경험은 여성의 요청에 의한 낙태 시행, 낙태를 위한 의사의 복잡한 입증을 전제로 하지 않는 낙태제도, 투명하고 익명성이 보장되는 정보제공 및 상담, 임신 초기단계의 빠른 낙태 결정, 의료진의 질 높은 낙태를 위한 교육 및 훈련, 낙태 서비스의 공공지원을 통한 모든 여성의 낙태 접근도 향상, 안전한 낙태를 위한 지속적인 모니터링 및 체계 구축 등과 같은 장치가 안전한 낙태를 위해 한국 사회에서도 시급하다는 함의를 얻을 수 있었다. 여성의 요청에 의한 '안전한 낙태'와 원치 않는 임신의 예방정책이라는 두 가지 전략을 통해 건강한 여성과 사회가 재생산될 수 있다.