• Title/Summary/Keyword: Micro Prime

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A Preliminary Study for Expending of Hospital-Based Home Health Care Coverage - Focused on Car Accident Inpatients Who has the Compensation Insurance - (병원중심 가정간호관리대상 범위 확대를 위한 기초연구(II) - 자동차보험가입 입원환자를 대상으로 -)

  • Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.7 no.1
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    • pp.58-72
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    • 2000
  • This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting 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 the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical 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 test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

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Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital (3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구)

  • Ryu, Ho-Sihn
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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Physicochemical Properties and Biological Activities of Protaetia brevitarsis seulensis Larvae Fermented by Several Kinds of Micro-organisms (유용 미생물을 이용한 발효굼벵이 추출물의 이화학적 특성 및 생리활성효과)

  • Sim, So-Yeon;Ahn, Hee-Young;Seo, Kwon-Il;Cho, Young-Su
    • Journal of Life Science
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    • v.28 no.7
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    • pp.827-834
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    • 2018
  • In this study, the biological activities of aqueous, ethanol, and methanol extracts of larvae of the edible insect Protaetia brevitarsis seulensis, fermented using several kinds of microorganisms, were tested in in vitro experimental models. Six effective microorganisms were used for fermentation, namely Lactobacillus plantarum JBMI F3, Lactobacillus plantarum JBMI F5, Lactobacillus gasseri Ba9, Aspergillus kawachii KCCM 32819, Saccharomyces cerevisiae KACC 93023, and Bacillus subtilis KACC 91157. Biological activities (${\alpha},{\alpha}^{\prime}-diphenyl-{\beta}-picrylhydrazyl$ [DPPH] free radical scavenging activity, reducing power, and fibrinolytic activity), and biochemical properties (phenolic compounds and flavonoids) were examined in aqueous, ethanol, and methanol extracts from P. brevitarsis seulensis powder and fermented P. brevitarsis seulensis powder. The total phenolic compounds and flavonoid contents were highest in the aqueous extract of B. subtilis-fermented P. brevitarsis seulensis powder. DPPH radical scavenging activity and reducing power were stronger in the fermented group than the nonfermented group. Fibrinolytic activity were highest in the extract from B. subtilis-fermented P. brevitarsis seulensis powder. The ${\alpha}-amylase$ activity in starch was higher in the fermented group than the nonfermented group, but there was no significant difference. These results provide basic data to understand the biological activities of bioactive materials derived from fermented P. brevitarsis seulensis larvae for the development of functional foods.

The Plant Species Composition and Phytogeographical Significance on Algific Talus Slope in Korea (한반도 풍혈지의 종조성과 식물지리학적 중요성)

  • Kim, Jin-Seok;Chung, Jae-Min;Lee, Byeng-Cheon;Pak, Jae-Hong
    • Korean Journal of Plant Taxonomy
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    • v.36 no.1
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    • pp.61-89
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    • 2006
  • Algific talus slopes are local cold micro-environmental habitats where cool air escapes through vents and fissures of talus layer, and ice forms in summer. To access the phytogeographical significance and to develop the conservation strategy on vegetation of the algific talus, plant species composition on seven algific talus in South Korea was investigated. As a results, phytogeographically significant northern elements such as Cystopteris fragilis (L.) Bernh., Diplazium sibiricum (Turcz. ex Kunze) Sa.Kurata, Polypodium virginianum L., Vaccinium vitis-idaea L. and Hackelia deflexa (Wahlenb.) Opiz were distributed in these algific talus slopes (below $N37^{\circ}43^{\prime}$). In addition, subalpine species such as Woodsia subcordata Turcz, Rosa suavis willd., Clematis fusca var. coreana ($H.L{\acute{e}}v.$ & Vaniot) Nakai, Calamagrostis langsdorfii (Link) Trin. and Carex vaginata var. petersii (C.A.Mey.) Akiyama were also distributed as typical relictual species of these algific talus (less than alt. 400m). The algific talus slopes in Korean peninsular can be regarded as the insular refugia that northern plant species advanced southward during the latest glacial age have been isolated and adapted in some local microhabitats. Because the algific talus slopes as paleorefugia are very important in terms of phytogeography as well as meteorology ans geology, developments of strategies for in situ and ex situ conservation on these small isolated and threatened populations associated with the algific talus urgently needed.

The life and medical idea of Chu, Dan-Gae.(朱 丹溪) (주단계(朱丹溪)의 생애(生涯)와 의학사상(醫學思想)에 관한 연구(硏究))

  • Lee, Yong-Won;Yoon, Chang-Yeul
    • Journal of Korean Medical classics
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    • v.5
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    • pp.200-251
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    • 1992
  • As concerned the life and the medical idea of Choo, Tan-Kye(朱丹溪), which it can be summarized as follows by studying. 1. Tan-Kye(丹溪) lived in the end of the won dynasty(元代末期), When the people starved and suffered from a flood-disaster and drought. etc, also the social conditions were in disorder on account of the corrupt ion of politics. And Cheol Kang seong(浙江省), located in the south region of China, has sterile soil and the climate condition humid and heatful. So the south district peoples have very weak constitution. So We can found that his medical idea reflected the phases of the periods and the regional enviornmental situations. 2. For that reason, Tan-Kye(丹溪) rejected the prescription of the "WHa Che Gook Bang(和劑局方)" which was prevalent at that time, in which the the pungent-dried herbs were widly used ; So he persisted in the "Sang Wha Lon(相火論)" and the "Positivity is usually excedeed while the negativity deficient(陽有餘陰不足論)". Then he treated with the drugs to nourish the negativity for the prime object to be applied in the clinic. 3. Tan-Kye(丹溪) refined the follows from the natural law; Heaven is to the positivity(陽) and the Earth is defined the negativity(陰), so the heaven is to the Macro(大) and the earth, micro(小):So the Sun is to the Positivity(陽), the Moon, the Negativity(陰): as to the Sun is always full while the moon always defected too. Therefore the "positivity is always excedeed for that the negativity is deficientalways(陽有餘陰不足)". In Human body, "the negativity energy (陰精) "is hard formed-easily defected(難成易虧)". And the heat(相火) in the body can be moved easily and let the negative energy to leak out. Therefore the more the positivity excedeed, the more the negativity deficient"(陽當有餘陰常不足). 4. He made it expanded the contents of the "Heat(相火)" in the Chapter Woon Chi of the Nae Kyeong(內徑) and discribed, the Life-string of the human body is originated from the movement of the "Heat with unique energy(相火一氣)". And more in human body, it is specifically regulated by the two visceras, Liver and Kidney, and is distributed in the 'Pericardium(心包絡)' 'Tripie Warmer(三焦)' 'Gallbladder(膽)' etc. In the point of his assertion of heat(相火), it is concluded both the physiological and the pathological heat of all. 5. Tan-Kye(丹溪) grew up in the family or the Confucianism. He was instructed the Confucianism(性理學) from Heo-Kyeom(許謙), the fourth diciple of Chu-Ja(朱子), and was received the Yoo Chang Ri(劉 張 李)'s triple doctrine from the La Tae Moo(羅太無), the second disciple of Yoo Wan So(劉完素). So there are much of content of Confucianism(性理學) in his medical thedry, and his theory has succeeded the achievements of the triple study. 6. About the theory of the "positivity is usually excedeed while the negativity deficient"(陽常有餘陰常不足論) of Tan-Kye, it was asserted that the positivity is never sufficient for the vital mainspring, by Chang, Kye-Pin(張介賓) and Lee, Kyoo-Zoon(李奎晙) etc. And for the Heat theory(相火論), eventhough the scholars of postorior generations criicized all of that, there are defect of the content and unification between them. 7. The father of the "Cha Eum Pa(滋陰派), Tan-Kye(丹溪) contributed considerably to the development of the oriental medicine and to the general therapy for the various diseases(一般雜病施治). 8. there are handed down and remained twenty or more of volumes of list of his writings. Among them, except "Kyeok Chi Yeo Ron"(格致餘論), "Kuk Pang Pal Hyeu"(局方發揮), they are reorganized by posteriority. There are Cho, Do-Chin(趙道震). Cho, Ee-Teok(趙以德), Tae, Sa-Gong(戴思恭), Wang Ri(王履) and Yoo, Suk-Yeon(劉淑淵) etc as disciples of his. And Wang Ryoon(王論) and Woo Pak(虞搏) as the admirer of him.

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