The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.
Purpose: The purpose of this study is to identify the relationship between perceived smartphone addiction and physical and mental health among female college students. Methods: Data were collected using a questionnaire to measure perceived smartphone addiction and physical and mental health of 314 female students attending a college located in D city from April 9 to May, 31, 2019. The collected data were analyzed using descriptive statistics, 𝑥2 test, t-test and stepwise multiple regression with SPSS 18. Results: The respondents were classified into two groups, the perceived smartphone addiction group (29.3%) and the perceived smartphone non-addiction group (70.7%). Perceived smartphone addiction was significantly different according to daily smartphone usage time (p<.001), smartphone usage fee (p=.005), most satisfying thing about using smartphones (p=.006) and importance of smartphones in daily life (p<.001). The perceived smartphone addiction group had more physical health problems (p=.001) and more mental health problems (p<.001). The factors affecting physical health were perceived smartphone addiction and importance of smartphones in daily life, with 62% of explanatory power (F=10.15, p<.001). As for mental health, the affecting factors were also perceived smartphone addiction and importance of smartphones in daily life, with 87% of explanatory power (F=14.52, p<.001). Conclusion: It is important to raise awareness of smartphone addiction including its negative impact on physical and mental health, reduce smartphone usage time, and build offline social relationships.
Purpose: The objectives for this study are to produce the comprehensive management indexes and find their application strategies for appropriate medical care in primary care clinics under workers' compensation insurance. Method: Data of this study was workers' compensation insurance medical fees claim's data from July 2006 to June 2007. Data were analyzed using SAS 9.1 version by applying descriptive statistics and Pearson's correlation. The indexes such as costliness index(CI), standard medical fee were calculated based on the fourth revision of korean classification of diseases(KCD-4.). Results: The CI, visiting index(VI), outliers index(OI), and medical review adjustment percentage were positively correlated in the both inpatient and outpatient medical fees in primary care clinics under workers' compensation insurance. The major medical specialities were neurological surgery, general medicine, general surgery, rehabitational medicine, and orthopedic surgery. The CIs were slightly high in rehabitational medicine among major medical specialities. The CIs were mostly high in diagnosis, test, anesthesia, and rehabitational assistive device fees among major medical specialities. The CIs were slightly high in Kwangju, Daegu, Daejeon, and Busan districts among district management centers of Korea Workers' Compensation and Welfare Service. Conclusions: We suggest the continuous development of appropriate disease classification system and medical care quality indicators to successfully take root the comprehensive management for appropriate medical care under workers' compensation.
This study was conducted to provide insight into the management and care of the elderly in nursing homes. Eighty-six elderly subjects over 65 years old (38 male, 48 female) in 3 non-fee-paying nursing homes, located in Daejeon and Chungchong areas, were studied. Subjects'dietary intakes by estimated food intake records, and self-perceived health conditions, were studied using questionnaires from July 21 to August 1, 1997. Twenty-one % of the male subjects and 42% of the female subjects were over 80 years. Their predominant past occupation was farming. While 8.3% of the female and no male residents showed a BMI (Body Mass Index) of 27 and above, about 30% of the subjects were underweight and in poor health status in seeing, joint pains, lumbago and shoulder pains. Regarding overall health status, 72.1% of the subjects considered them to be in poor health, and female and male subjects suffered more difficulties from cloudy eyes, joint pains and lumbago and shoulder pains than any other. Neuralgia was the predominant chronic complaint and followed by hypertension in both sexes. Overall, female subjects felt worse off than the male subjects in terms of their health status, that can be attributed to higher average age of the female subjects compared to the male subjects. The elderly were eating a very low fat (about 15 g : 6% of total calorie) diet with low vitamin A and E. Intakes of calories, protein and iron slightly exceeded RDA. The phosphorus intake was more than double the RDA although calcium intake was close to the RDA. From these results, it seems important to doubling the fat intake of the elderly residents in the form of vegetable fat with the object of raising of vitamin E, antioxidant vitamin, and essential fatty acids for the elderly. It is also recommended that the elderly residents should be given adequate calcium and exercise for bone health.
Objectives : The purpose of this study is to examine the recognition and needs on the national health insurance coverage of scaling in industry accident injury patients. National health insurance coverage of dental scaling will start in September, 2013. Methods : Subjects were 649 industrial injury patients and they completed self-reported questionnaire. Data were analysed using SPSS version 20.0 for percentage, chi-square test, t-test, ANOVA, post-hoc Scheffe test, and Pearson's correlation coefficient. Results : Recognition on national health insurance coverage of dental scaling was not fully known to industrial injury patients (24.5%). Highly educated and high income workers seemed to recognize national health insurance coverage of dental scaling (p<.001). Recognition for national health insurance coverage of dental scaling revealed a significance (r=.576, p<.001). Most of the industrial injury workers thought that 50,000 to 100,000 Korean Won of dental scaling fee is reasonable. The coverage of dental scaling should be more than twice over 20 years old. Conclusions : It is necessary to encourage the patients to take regular dental scaling checkup and make them know the health insurance coverage of scaling. The preventive oral health care may improve oral health care and quality of life.
With the improvement of current medicine, the number of the chronicly ill children are increasing. The illness of the child drives all of the family to despair. especially it is a burden on the mother who takes care of the ill child. She's faced with many emergencies and feels powerless. The home care for a child is for finding a child's problems early and mediating them. The purpose of this study was to investigate the mother's reaction following their chronicly ill child's discharge and to investigate the supporting needs for caring for an ill child. The subjects of this study were mothers with a chronicly ill child being discharged from a general hospital in Seoul and the data was collected from July 20 to September 30. Data was collected by using questionnaires which were developed by the researcher. (The questionnaires were composed of the average 5 points - Likert's method). The Mother's reaction means that the higher the score, the more negative the mother's thoughts about discharge are. Supporting need for caring for ill an child means that the higher the score, the higher the demand of nursing is. The statistical analysis used the SPSS program for t-test. ANOVA, and Pearson Correlation. The results of this study were as follows: 1. The mother's reaction scores following discharge were the lowest. 19 and the highest 72 so that the total average was 43.15. The answer, 'I worry that my baby will be troubled with illness again after discharge gained the high points (3.94 of 5 points). The answer. 'The discharge of my baby makes me gloomy' gained 2.05-it was the lowest points. Their were significant differences according to religion (p=.006). salary (p=.050). the burden of the medical fee (p = .005) and caregiver (p=.027). 2. Supporting Need for caring for ill an child was the lowest 15 and the highest 67. the total average was 47.87. The answer. 'I'd be glad to get a person whom I could always get counsel about the health of my baby with' scored the high point (average 4.04 of 5). The answer. 'Caring for my baby at home makes me exhausted' gained the lowest point. 2.49. Their were significant differences according to religion (p=.019) and diagnosis (p=.019). 3. The relationship between the reaction of the mother and supporting need for caring for an ill child was a positive correlation (r=0.585). In conclusion. this study revealed that mothers weren't positive about their chronicly ill child's discharge and they wanted to get support for caring for an ill child. Through this study. I proposed that the program to support the chronicly ill child at home and home care by continuous counselling after discharge should be develop.
Objectives : To gather information about the factors which influence the interest and intention of admission into charging nursing hones for the elderly(CNH), as these homes represent an important method for resolving the problems related to the rapid population aging occurring in Korea. Methods : A face-to-face interview survey was carried out with 320(men 159, women 165) patients over 60 years old who were admitted at 2 university hospitals and 5 general hospitals in the Busan area between December 1998 and March 1999. Data were analyzed through t-test, ANOVA, correlation and multiple regression analysis. Results : The mean age and years of education of the study population was 67.0 and 7.7 years, and the types of chronic degenerative disease included musculoskeletal disorders(20.1%), cerebrovascular disease(17.1%), and diabetes(14.3%). The major forms of household living arrangement prior to admission were elderly alone(22.6%), and elderly couple(33.5%), while about half of them(55.5%) didn't want to live with their children id the future. Almost half were paying medication fees by themselves(46.6%). The level of actual intention of admission$(3.07{\pm}1.39)$ into a CNH was lower than that of interest$(3.22{\pm}1.33)$(p<0.01). Multiple analysis revealed that the intention of admission increased with decreasing number of future supportive persons$(\beta=-0.107)$, lower level of activity in daily life$(\beta=-0.447)$, and longer years of education$(\beta=-0.447)$ with 32.7% of $R^2$. As for the factors which determined the admission into a CNH, the fee and facilities were considered to be most important, and professional nursing and physician's care were the most desired services. In nomenclature, they preferred 'elderly hospital' or 'elderly health center' to CNH. Conclusions : Interest in CNH is increasing recently, but existing studies about patient experiences in CHN are still limited. This study may form a basis for future examinations of the needs and uses for CNH. Active financial support and public information are considered by the authors to be important factors for the induction of welfare services for the elderly, though CNH.
This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.
Kim, Nam-Hee;Kwon, Hye-Ri;Kim, Da-Hye;Kim, Da-Hee;Kim, Min-Hee;Yoo, Seung-Hee;Choi, Jin-Ah;Chung, Won-Gyun
Journal of Korean society of Dental Hygiene
/
v.7
no.4
/
pp.419-431
/
2007
The setting of dental hygiene clinics is very important to dental hygiene education, which is the place not only to educate students but also to care clients. The purpose of this study is to provide basic research material for improvement of dental hygiene care system in dental hygiene clinics by analyzing the client satisfaction. A questionnaire survey by means of self-entry method was conducted to find out satisfaction of the client, who was visited to the dental hygiene clinics in the department of dental hygiene, Yonsei University. An analysis of frequency, one way ANOVA and T-Test were performed through SPSS 12.0K program. 1. Most clients were mainly composed of students in Wonju College of Medicine. 2. The clients visited for scaling(85.8%) and oral examination(9.73%) were much than treatment(4.42%). 3. Clients aged 21 to 25 were relatively lower in satisfaction with the facilities, system, attitude than any other ages. 4. The dental hygiene students are the lowest group in satisfaction with the facility, system, attitude than medical and nursing students. 5. The clients satisfaction with dental hygiene clinics was decreased in reverse proportion to visiting frequency. 6. Most of the clients pointed out the problems of appointment system(54.0%) and fee(23.0%), which should be improved than any other operation conditions. 7. Most of the clients were not satisfied with chair time and pain during care. 8. Most clients recognized to receive the better care service than other dental offices(81.3%). Especially, they paid attention to oral health education using phase-contrast microscope. 9. Many clients were dissatisfied with facilities of the dental hygiene clinics(71.7%). The problems of appointment system(54.0%) and chair time of dental hygiene care services(63.6%) had also inconvenienced to clients. The dental hygiene clinics in school play a crucial role in dental hygiene education to foster the student to be competent as a professional dental hygienist in the future. Therefore, well-organized dental hygiene care program based on dental hygiene process is essential. It is also required to improve the environment of dental hygiene clinics including facilities, appointment system and fee etc.
The purpose of this study was to explore the degree of stress in caregivers caring for CVA patients and the level of daily living performance of CVA patients. The subjects for the study were caregivers of 112 CVA patients who enter a hospital or out-patient-department (OPD) at two Oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL check list for daily living performance of patients and Choi's 4 sore scale for stress of caregivers. The survey was conducted from July 4th to August 30th in 1999. The survey results were analyzed with the Statistical Package for Social Science(SPSS) program and can be summarized as follows: 1. The level of daily living performance for the CVA patients was: 1) complete dependence (M=14.9, 13.1%), 2) complete independence (M=23.6, 20.9%), 3) incomplete independence (M=23.9, 21.0%), 4) incomplete dependence (M=26.6, 25%), 5) dependence and independence (M=23.0, 20.0%). The items for with there was a high level daily living performance were: 1) drinking (M=3.62), 2) eating(M=3.25). 3) position returning (M=3.18) : and the items for which there was a low level of daily living performance were: 1) ascending and descending stairs (M=2.08), 2) walking (M=2.47), 3) dressing and undressing trousers (M=2.55). 2. Degree of caregiver stress was: Mean=2.39 at 40 score. The items for which was a high level caregiver stress were: 1) medical fee (M=3.25), 2) being handicapped or recurrence (M=3.02) : and the items for which there was a low level of caregiver stress were: 1) discontinuity of patient's treatment (M = 1.98). 2) change of home atmosphere caused by patient's disease (M = 1.98), 3) desire of patient's knowing about disease (M= 1.99). 3. There was statistically significant difference in the degree of caregiver stress according to the following caregiver's demographic characteristics: education level (F=3.52, P=0.03). change of caregiver (F=5.41. P=0.02). 4. There was a statistically signifiant difference in the level of daily living performance according to the CVA patients demographic characteristics: patient's paralytic status (F=4.48, P=0.01), duration of disease (t=2.76, P=0.03). 5. There was significant difference in degree of caregiver stress according to the CVA patient's demographic characteristics: CVA status (F=4.75, P=0.01). 6. There was statistically significant difference in the degree of caregiver stress according to the level of daily living performance in CVA patients(r=-0.482, P<0.00).
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