• 제목/요약/키워드: Nursing service environment

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행위별 수가 지불제도 하에서의 사례관리시스템 개발 및 경제성 분석 (Development of Case Management System and Analysis of Economic Feasibility under the Fee-For-Service Reimbursement)

  • 최미영;채영문;탁관철;김인숙;천자혜
    • 한국의료질향상학회지
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    • 제11권1호
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    • pp.46-60
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    • 2004
  • Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

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청소년기의 건강증진과 학교보건교육의 발전방향 (Adolescent Health Promotion and Development of School Health Education)

  • 유재순
    • 한국학교보건학회지
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    • 제11권1호
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    • pp.27-50
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    • 1998
  • Adolescent health is considered to contribute to health promotion in the home and community in the near future as well as individual health. However, adolescent health has been neglected from education field because of competitive school education focused on the university entrance examination That's why I suggest in this study that we should pay much more attention to adolescent health condition and try to make It better, in terms of man-power development and life-health promotion for nation development The purposes of this study are as follows First, to look into a variety of adolescent health problems Second, to find out the situation and problems of current adolescent health promotion and school health education Third, to make an effort to find, based on the current situation, various developments of adolescent health promotion and school health education in terms of practical, political and environmental change There are used study methods as adolescent-related, school heath-related literature review and anlysis of statistical data The results and suggestions are as follows Teenagers have a great variey of health problems including most Important physical, mental and social developments Recently, chronic diseases, emotional problems, health-risk behaviors linked With adolescents are on increase The complicated disorders of physical, mental, social health rather than paricular aspects of health or health-behavior problems influence adolescent health problems adolescence is regarded as the period when most health-related behaviors are formed. Therefore, adolescent health promotion would he assured by developing the ability of controlling multi-dimensional health determinants in the early stage. Health promotion is a positive concept that each individual, family and community makes real efforts to improve their health To achive this, we need health educational, organizational, political and environmental supports. Adolescent health promotion in Korea has been systematically treated in the category of school health Current school health services have had lots of systemic, constitutional, administrative and educational flaws Accordingly, I'm concerned that we can afford to accept a variety of adolescent health needs However, I would say that if were not to make those flaws better, it's certain that Korean national competitive power and the quality of the lives of most Koreans Will he threatened someday We have to develop Comprehensive School Health Crriculum(CSHC) and set up its standards to Improve adolescent health. CSHC is an organizational and costant process. CSHC means an Important part of overall curriculums. In addition, I could say that it's an Important school health education acivity including current school health services-health care service and school health environment. In conclusion, in order to develop CSHC, we require school nurse's role changes, establishment and management of intergrated subject of health education, striking revision of school health law(or legislation of school health promotion law), reorganization of administration system, big changes in curriculum for school health educators.

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환경호르몬 노출 위험행위, 직업환경 및 환경호르몬 관련 생활습관이 자연 유산 발생에 미치는 영향 (The Effect of Exposure-Risk Behavior toward Endocrine-disrupting Chemicals, Occupational Environments and Daily Habits Related to Endocrine-disrupting Chemicals on Development of Spontaneous Abortion)

  • 최명희
    • 한국융합학회논문지
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    • 제11권7호
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    • pp.377-387
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    • 2020
  • 본 연구는 가임기 여성의 자연 유산 발생에 영향을 미치는 요인을 파악하기 위한 후향적 서술적 조사연구이다. 연구대상자는 출산 또는 자연 유산의 임신 결과를 1회 이상 경험한 적이 있는 만 20~45세의 여성 198명이었으며, 구조화된 자가보고형 설문지를 이용하여 2019년 7월부터 한 달 동안 자료를 수집하였다. 연구결과, 자연 유산 발생에 영향을 미치는 요인은 임신 중 팬티라이너(매일: 기준, 주 1~2회: B=-1.74, 사용하지 않음: B=-0.77)와 항균제 사용 양상(자주 또는 많이: 기준, 소량 또는 보통: B=-0.71, 사용하지 않음: B=0.79), 직업군(무직: 기준, 서비스 종사자: B=0.73, 사무직: B=1.22, 전문직: B=0.63, 관리자: B=1.54) 및 환경호르몬 노출 위험행위(B=0.81)였으며, 이들의 설명력은 24.4%(R2=.24)였다. 이러한 결과에 따라 자연 유산 발생을 감소시키기 위하여 임신 중 환경호르몬 노출을 예방하고 직업환경에 유의하는 것이 필요할 것으로 생각한다.

연세대학교 치위생학과 구강위생교육실을 방문한 대상자의 구강위생관리 서비스체계에 대한 만족도 조사 (Clients Satisfaction with Oral Hygiene Care Services System Provided by the Dental Hygiene Clinics in the Department of Dental Hygiene, Yonsei University)

  • 김남희;권혜리;김다혜;김다희;김민희;유승희;최진아;정원균
    • 한국치위생학회지
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    • 제7권4호
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    • pp.419-431
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    • 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.

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한국 노인의 넘어짐과 연계된 인체손상에 대한 이해와 예방: 체계적 문헌 고찰 (Understanding and Prevention of Fall-related Injuries in Older Adults in South Korea: A Systematic Review)

  • 임기택;이지은;박하은;박수영;최우철
    • 한국전문물리치료학회지
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    • 제26권2호
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    • pp.34-48
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    • 2019
  • Background: Fall-related injuries in older adults are a major health problem, and the risks and mechanisms of these injuries should be affected by race, culture, living environment, and/or economic status. Objects: Research articles have been systematically reviewed to understand fall-related injuries in older adults in South Korea. Methods: 128 published research papers have been found through the Korea Citation Index and the Korean Studies Information Service System, and reviewed in various perspectives, including incidents, fall death rates, medical costs, causes, injury sites and types, locations where falls occurred, prevention strategies, scholarly fields interested in fall injuries, and the role of physical therapy. Results: Fall-related injuries were found to be more common in women than in men, and the number of incidents increased with age, with the highest rate found in individuals over 85 years old. Risk of fall injury was associated with education level, comorbidities, and fear of falling. Common places where falls occurred included the bathroom, living room, stairs, and hallway. Common types of injury included bruises, fractures, and sprains in the lower extremities. Intervention strategies included exercise programs, education, and protective clothing. Scholarly fields interested in fall-related injuries in older adults included medicine, nursing, physical therapy, occupational therapy, physical education, pharmacology, oriental medicine, biomedical engineering, design, clothing, and textiles. Physical therapy intervention using proprioceptive neuromuscular facilitation has been used to improve one's balance. Conclusion: Any movement during the activities of daily living can lead to a fall. Physical therapists are highly educated to analyze human movements and should be involved in more research and practices to solve fall-related injuries in older adults.

일본 프랜차이즈사업 구조 분석을 통한 한국기업의 해외진출 전략에 관한 연구 (A study on the Korean Company's Overseas Expansion Strategy Through Japan Franchise Business Structure Analysis)

  • 조혜덕;이상윤
    • 한국프랜차이즈경영연구
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    • 제4권1호
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    • pp.73-90
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    • 2013
  • 프랜차이즈 산업은 우수한 경영 노하우와 기업의 경영자원을 유기적으로 통합하는 지식산업이다. 또한 프랜차이즈 산업은 국가의 경제성장에 지속적으로 기여하는 바가 크고, 기업의 성장에도 영향을 미치고 있다. 이러한 프랜차이즈 산업 부문에서 일본 프랜차이즈 산업은 여타 산업에 비해 꾸준한 성장률을 보이고 있으며 장기간 경기 침제에도 불구하고 최근 회복세를 보이는 경향을 나타내고 있다. 따라서 일본 프랜차이즈 산업의 구조분석을 통하여 한국 기업의 프랜차이즈 산업의 해외진출에 대한 전략을 알아보고자 한다. 따라서 본 연구에서는 일본의 정체기를 벗어나는데 시발점을 제시한 2009년부터 2010년의 일본 프랜차이즈 체인협회 통계 조사와 각국 프랜차이즈 시스템의 비교 분석을 통하여 일본 프랜차이즈 사업구조와 해외진출 전략을 파악하고 그 연구 결과를 토대로 하여 한국기업의 해외 진출 전략을 수립하는데 목적을 두고 있다. 이러한 목적을 위하여 문헌고찰과 통계분석 결과 업종별 체인수와 점포수, 매출액의 추이를 통해 다음과 같은 4가지 결과를 도출 하였다. 1)서비스를 중점으로 한 프랜차이즈 활성화 방안 마련 2)서비스 프랜차이즈의 흐름으로 고령화, 간병, 건강지향, 유아교육, 미용과 관련된 사업 성장 기대 3) 일본의 문화와 인식의 차이를 고려한 서비스 업종 파악의 증요성 4)서비스 사업의 생산성을 높이는 노력에 대한 필요성으로 정리하였다. 본 연구의 결과를 바탕으로 한국기업은 프랜차이즈 산업의 해외진출 전략 수립에 있어서 일본 프랜차이즈 산업의 제도적 환경과 문화 인식의 차이를 고려하여 전략을 수립해야 한다.