• Journal of Digital Convergence
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• v.15 no.7
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• pp.259-269
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• 2017

This study analyzed medical aid case management effects based on the number of access by visits, phone calls, letters, internal investigation, resource links, and requests, in medical aid case management business that is carried out to improve the quality of life of medical care beneficiaries and reduce financial cost. Secondary analysis study using data of 564 high-risk group in the medical aid case management and their healthcare utilization data. Letters had positive correlations with the scores of all case management domains. The higher visits was, the lower the score of self-health care ability was, and the higher the number of phone calls was, the higher the score for reasonable medical use was. While there was no significant difference in medical cost according to aid management by interventions, the higher visits and resource links were, the lower the subjects' total number of payment days was. There is a difference in the various areas of the quality of health -related life and medical use depending on case management by intervention method and its number. It is necessary to carry out the efficient number of access to case management by intervention method.

• Journal of the Korea Convergence Society
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• v.9 no.8
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• pp.77-85
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• 2018

Dementia among the diseases occurring in the old age is recognized as a disease to be solved at the national level and systematic management is being carried out. However, the awareness and response of the mild cognitive disorder, which is the middle stage of normal aging and dementia, are insufficient and social costs are increasing every year. The subjects of the study were 303 hospitalized patients whose primary diagnosis was mild cognitive impairment (F067) in a nursing hospital located in one district in 2016. The number of days of hospitalization was shorter in autumn and longer in winter or in hospital discharge. The cost of treatment for patients with mild cognitive impairment is lower in autumn and higher in winter or in 'discharge' of medical treatment results. The total cost of medical treatment was high in the winter by season in the ADL 6-12 and ADL 13-20 groups. Difference in the cost of medical treatment according to the characteristics of medical treatment, the medical expenses were the highest when the number of corporal disease was 5 ~ 8. In the medical treatment results, the ADL 6-12 point group and the ADL 13-20 point group had high medical expenses in 'continue'. Considering the clinical characteristics of mild cognitive impairment and considering that 10-15% of the patients with mild cognitive impairment progress to dementia every year, early detection and treatment of mild cognitive impairment is an effective and potentially important task for reducing potential social and dementia patients.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.28 no.4
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• pp.435-442
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• 1995

The abalone shell (Haliotis) is one of the most important resources for the coastal fisheries and it is popular as an aquacultural species. Proper cultivating grounds for mid-term nursery of abalone spats are required before releasing them. It is difficult for us to find good enough aquacultural grounds to rear abalone spats to 20"30mm of shell length. Therefore, we need to study a practical and effective new type of aquacultural device for the nursing of abalone spats by using open sea areas. We can find this kind of studies from 'Marine aya No. 1' of Japan, Though they focused on the easy operation, safe working and low operating cost, it involves so much initial cost that it is difficult for us to justify such expenditure. However, with a modified small buoy system, this submersible facility needs only a horizontal frame to fulfill its essential function and the vortical part can be removed. The working boat equipped with a pump can operate this facility to keep it submerged or floated. This paper deals with the possibility of this submersible fishery facility for the mid term nursing of abalone spats in the open sea. A small version of this system to ensure low initial cost is suggested and wave and current forces were calculated for the estimation of the weight of the mooring anchor.

• Journal of the Korea Convergence Society
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• v.11 no.12
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• pp.409-418
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• 2020

The purpose of this study is to analyze the economic feasibility of public postpartum care centers established for health care of low-income postpartum mothers. 6 of 8 public postpartum care centers were used to verify the economic feasibility and research data were collected through the centers. A sensitivity analysis was performed with the bed turnover rate, assuming that users in a postpartum care center will be decreased. As a result, B/C ratio was estimated to be 1.50 and the net benefit was estimated to be KRW 186,557 in million. A sensitivity analysis showed that B/C was 1.42 at 17.4 of bed turnover rate and 1.26 at 15.4 which indicates the lowest bed turnover rate among subjects. A public postpartum care center was evaluated as economically feasible as public works. Therefore it is necessary that the public postpartum care centers operated by local governments should be expanded through legal amendment.

• Journal of Korean Academy of Nursing
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• v.44 no.4
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• pp.418-427
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• 2014

Purpose: Objectives of this study were to investigate the association between efficiency and quality of health care in Long-term Care Hospitals (LTCH) and determine related factors that would enable achievement of both high efficiency and high quality at the same time. Methods: Major data sources were the "2012 Korean Assessment of Propriety by Long-term Care Hospitals" obtained from the Health Insurance Review & Assessment Service. Cost variables were supplemented by a National Tax Service accounting document. First, data envelopment analysis was performed by generating efficiency scores for each LTCH. Second, matrix analysis was conducted to ascertain association between efficiency and quality. Lastly, kruskal-wallis and mann-whitney tests were conducted to identify related factors. Results: First, efficiency and quality of care are not in a relationship of trade-offs; thus, LTCH can be confident that high efficiency-high quality can be achieved. Second, LTCH with a large number of beds, longer tenure of medical personnel, and adequate levels of investment were more likely to have improved quality as well as efficiency. Conclusion: It is essential to enforce legal standards appropriate to the facilities, reduce turnover of nursing staff, and invest properly in human resources. These consequences will help LTCH to maintain the balance of high efficiency-high quality in the long-run.

• Quality Improvement in Health Care
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• v.7 no.2
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• pp.156-167
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• 2000

Background: Emphasis in healthcare during the 1990s has been to provide both optimal wellness and function with quality in a Cost-effective manner. Critical pathway was developed to meet the need to guide clients along the continunm of care and to achieve continuity of care. The purpose of this study is to review and analyze articles related to the critical pathway that had developed and applied in Korea and abroad from 1995 to 1999. Methods: Total 39 studies were analyzed in terms of group of application, need of development, horizontal axis: time frame, vertical axis : items of care, task force team, identification of preliminary critical pathway, validation of preliminary critical pathway, types of final critical pathway, a person who coordinates and effects on critical pathway. Results: In the aspect of group of application, there were various diseases in the overseas than in Korea. In domestic and overseas, the horizontal axis included mainly the time from the start of hospitalization to discharge and vertical axis of the critical pathway included commonly the following nine items : tests, diet, medications, consultations, activity, assessments, treatments, education, discharge planning. Preliminary critical pathway was mainly drawn up through chart review in both. Types of final critical pathway were mostly for medical team use in Korea and were for medical team and patient use in abroad. A person who coordinates critical pathway was mostly nurse in abroad. There was positive effects on critical pathway in both. Conclusion: Staff education and information about critical pathway are needed to use it effectively.

• Journal of Chest Surgery
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• v.52 no.6
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• pp.385-391
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• 2019

Background: Preoperative autologous blood donation (PABD) is a conservation strategy for reducing allogenic blood transfusion (ABT) during minimally invasive cardiac surgery (MICS). We aimed to evaluate the effects of PABD on the frequency of ABT and clinical outcomes in patients undergoing MICS. Methods: We enrolled 113 patients (47.8±13.1 years, 50 men) undergoing MICS without preoperative anemia (hemoglobin >11 g/dL) between 2014 and 2017. Of these patients, 69 (the PABD group) donated autologous blood preoperatively and were compared to the non-PABD group (n=44). We analyzed the frequency of perioperative ABT and clinical outcomes. Results: Baseline characteristics did not significantly differ between groups, although preoperative hemoglobin levels were lower in the PABD group. All operations were performed using a minimally invasive approach. Patients' surgical profiles were similar. There were no cases of mortality or significant differences in early postoperative outcomes. During the early postoperative period, hemoglobin levels were higher in the PABD group. No significant difference was found in the frequency of ABT. Conclusion: Although the PABD group had higher postoperative hemoglobin levels, there was no clear clinical benefit in the early postoperative period, despite a great deal of effort and additional cost. Additional PABD in the setting of strict policies for blood conservation was ineffective in reducing ABT for young and relatively healthy patients who underwent MICS.

• Asian Oncology Nursing
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• v.2 no.1
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• pp.50-60
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• 2002

Breast self-exam is easiest, safe and cost effective to be recommended as an important method for early detection of breast cancer. This experimental research with non-equal control design was to develop the efficacy expectation program for breast self-exam based on Bandura's self-efficacy information source. The study objects selected from two local churches in Busan. Twenty from S church were selected as a study group, twenty from D church as a control group. Efficacy expectation promoting program was based on Bandura's efficacy promoting source and was two hour lecture including slide, video tape, demonstration, pamphlet. After this, there were individual interviews with them and consultations through telephone f or verbal persuasion on the weekly basis between the first week and the fifth week. The effect from the experiment were measured on the first week after education and on the fifth week. Data from control group was collected during the period from Jan 11, 2 001 to Feb 15, 2001 and data from study group was collected during the period from Jan 12, 2001 to Feb 16, 2001. Measurement instrument for this study was developed by the author with the advice of specialist in order to measure self-efficacy and breast self-exam practice. Data analysis was done by using SPSS/10.0 PC program $with^2-$ test. t-test and ANCOVA. Proved results for hypothesis were as follows. 1) It was supported that "Study group educated by efficacy expectation promoting program has higher score in change rat e of self-efficacy than control group." (1 week after education F=18.395, p=.000 5 weeks after education F=28.972, p=.000) 2) It was supported that "Study group educated by efficacy expectation promoting program has higher score in change rate of exam practice than control group." (1 week after education F=37.984, p=.000 5 weeks after education F=28.972, p=.000) In conclusion, efficacy expectation promoting program for breast self-exam developed by this study may increase s elf-efficacy and breast self-exam practice.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.1
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• pp.66-73
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• 2011

Purpose: The purpose of this study was to demonstrate effects of a critical pathway (CP) for stroke patients seen in emergency rooms (ER). Method: The CP developed by the CP committee consisted of 8 criteria: behavior of doctors and nurses, laboratory tests, Image testing, medication, treatment, activity, and nutrition. According to application of CP, a control group (n=17) and experimental group (n=17) were defined. Time was checked by the electronic medical records. Result: Use of CP for stroke patients in the ER, resulted in a decreased length of stay in ER (t=2.341, p=.026), and time required for image testing (t=2.623, p=.021), and an increased number of patients using rtPA ($x^2$=4.802, p=.049). Time required for neurology doctor contact, for neurology doctor to see patient in the ER, and for report of blood tests decreased, but there were no statistical significance. Conclusion: Quick responses are most important in the ER, so CP for these patients is a very effective patient management tool. To reduce delay in stroke diagnosis, continuous education programs for similar symptoms are necessary. CPs for other patients in the ER should be developed, and studies on cost and satisfaction, as well as length of stay, should be done.

• Korean Journal of Health Education and Promotion
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• v.19 no.2
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• pp.155-167
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• 2002

This study was carried out to grasp visiting nurses' perception of the service referral between health and welfare with a view to providing the basic data for the visiting nursing activities. A questionnaire survey was conducted on public health nurses in 25 health centers in Seoul from Feb. 12, 2001 to Mar. 15, 2001. A total of 151 questionnaires were collected and they were analysed by use of SPSS/WIN 7.5. The results of the survey are as follows. 1. In general, visiting nurses were burdened with heavy workloads. On average, a visiting nurse covered 5 ‘dong's(the smallest administrative unit), 564 households, and 1223 persons. They spent almost a quarter of their working hours moving from home to home and recording the charts after home visiting. They took 30-60 minutes to provide their services when visiting homes. As for the frequency of home visiting, they were following the instructions recommended by the government. However, their services were still wasteful, not skill-oriented, in that they spent more time assessing ‘subjects’ rather than providing their ‘services’ for them. 2. As for the degree of service performance, visiting nurses scored average 2.94 and 2.28 on the four-point scale in the area of health and welfare respectively. The Pearson coefficient between the two variables was high(.56). According as the health services increased, the welfare services increased as well, which showed that the service referral between the two areas should be essential. 3. ‘The necessity of cooperation with social welfare staff’ scored average 4.49, and ‘the degree of cooperation with social welfare staff’ scored average 3.16 on the five-point scale; There was a statistically significant difference (average 1.33) between the two variables. Such a big difference between perception and practice results from the lack of political support that connects the two service areas comprehensively. Therefore it is recommendable to establish a so-called ‘Visiting Nursing Center’ in the ‘dong’ office in order to provide integrated services of health and welfare at once in cooperation with social welfare staff. That's the way to meet the public needs directly and it's more efficient as well in terms of cost-saving.