• Health Policy and Management
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• v.32 no.2
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• pp.173-179
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• 2022

Background: This study aimed to identify patterns of elderly patients who transferred from long-term care hospitals to emergency rooms and provide the evidence of emergency medical systems to prepare for a super-aged society. Methods: The data source was the National Emergency Department Information System database from January 2014 to December 2019 in Korea. We performed a cross-sectional study among elderly patients (≥65 years) who transferred from a long-term care hospital to an emergency room. Trend analysis was conducted by year. Results: We identified 225,765 elderly patients who were transferred from long-term care hospitals to emergency rooms between January 1, 2014 and December 31, 2019. The proportion of the study population and their mean age were recently increased (p<0.001, respectively). The proportion of elderly patients being re-transferred (p=0.049) and the patients re-transferred to long-term care hospitals is significantly increased (p=0.005). Conclusion: The establishment of efficient emergency medical services for an aging society is important. It is necessary to develop a healthcare network with the government, long-term care hospitals, and medical institutions in the community suitable for preventing disease deterioration.

• Journal of Preventive Medicine and Public Health
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• v.9 no.1
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• pp.31-37
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• 1976

This study was conducted for the purpose of obtaining basic information on the patterns of medical care expenditures, and identifying some determinants of medical care expenditures in the rural Korea. Nine guns were chosen from the eight provinces, excluding Cheju island. One gun in each province and two villages were selected from the each myon or ub within the selected guns. The total number of households was 1,789 and the sample size was 9,826 non-institutionalized people. Followings are the major findings of the study : 1) Medical care expenditures increase proportionally with age in terms of cost per patient, per episode of illness, per treated case, and per person. Averagely, it cost 2,756 won per patient, 2,614 won per spell of illness, 4,361 won per treated case, and 413 won per person. 2) Medical care expenditures increase proportionally with educational level of patients. College graduates spent the most, 4,726 won per patient, 5,987 won per treated case, and 670 won per person. 3) The male spent a little more than the female in terms of per patient, per episode, and per person. For example, a male spent 23 won more than a female. 4) Those who were suffering from illnesses longer than 1 year spent three times more than that had illnesses of less than 1 year duration. 5) The simple correlation coefficient between activity restriction and medical care expenditures was the highest among others, 0.491. The next was 0.294 between duration of illness and medical care expenditures. 6) Attempts are made to identify the explanatory variables in medical care expenditures. Thirty one per cent of the variances in tile expenditures can be accounted for by the selected 15 predictors. Those predictors belonged to clinical renditions, such as activity restriction, duration of illness, and nature of conditions, are proved to be the most potent independent variabes. Level of education and monthly family income are also significant in terms of beta coefficient. Further studies are called for to unreveal the determinants of medical expenditures.

• The Korean Journal of Health Service Management
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• v.8 no.3
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• pp.103-112
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• 2014

The purpose of this study is to explore and classify the types of the attitude on a good death of nurses in long-term care hospitals. Q-methodology, which is effective in scientifically measuring individual subjectivity, was used. 151 Q-population were selected through the processes of review of research articles, newspaper articles and interviews. 34 Q-sample were selected from the 151 Q-population and 27 nurses in long-term care hospitals were invited as the P sample. The result of the Q-sort was analyzed using PC QUANL Program. The types of attitude on a good death of nurses in long-term care hospitals was categorized into three. 1) Death in supportive environment 2) a comfortable death in real life 3) Dignity guaranteed death By identifying 3 attitude patterns toward a good death of long-term hospital nurses, this study provides an opportunity for their reflection and recognition toward a good death based on this result and suggests to think about ways to improve the quality of nursing in the current increasing long-term hospitals.

• Advances in Computational Design
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• v.2 no.4
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• pp.293-311
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• 2017

There are several claimed benefits for the impact of design patterns (DPs) on software quality. However, the association between design patterns and fault-proneness has been a controversial issue. In this work, we evaluate the fault-proneness of design patterns at four levels: the design level, category level, pattern level, and role level. We used five subject systems in our empirical study. As a result, we found that, at the design level, the classes that participate in the design patterns are less fault-prone than the non-participant classes. At the category level, we found that the classes that participate in the behavioral and structural categories are less fault-prone than the non-participant classes. In addition, we found that the classes that participate in the structural design patterns are less fault-prone than the classes that participate in the other categories. At the pattern level, we found that only five patterns show significant associations with fault-proneness: builder, factory method, adapter, composite, and decorator. All of these patterns except for builder show that the classes that participate in each one of them are less fault-prone than the non-participant classes in that pattern. The classes that participate in the builder design pattern were more fault-prone than the non-participant classes and the classes that participate in several patterns: the adapter, the composite, and the decorator design patterns. At the role level, the most significant differences were between the classes that participate in some roles and the non-participant classes. Only three pairs of design pattern roles show significant differences. These roles are concrete-product vs. concrete-creator, adapter vs. adaptee, and adapter vs. client. The results recommend the use of design patterns because they are less fault-prone in general except for the builder design pattern, which should be applied with care and addressed with more test cases.

• Journal of Families and Better Life
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• v.21 no.3
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• pp.39-46
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• 2003

There are three main purposes in this study. First, we project the number of elderly dementia population in the future based on the projection of the elderly population in the Kyungpook area. Second, the demands of home-based care service and facility-based care for the elderly dementia are estimated. Thirdly, some policy implications for the improvement of welfare services for the elderly dementia are addressed. The findings of this study are as follows. Considering the size of the elderly dementia population, facilities for the elderly dementia are extremely insufficient and most of the elderly dementia patients rely heavily on home-based care. Although we expect that there will be a rapid increase in the number of the elderly dementia in the next two decades, the social welfare services for them in the future are very unreliable. Home nursing for the demented elderly needs to be recognized by law and financed by the government. In this context, we address some issues regarding the rapid growth of the elderly dementia population in the future and social welfare services for them as well. Finally we suggest some policy implications regarding this matter.

• Quality Improvement in Health Care
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• v.17 no.1
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• pp.69-78
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• 2011

Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

• 대한상한금궤의학회지
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• v.5 no.1
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• pp.75-84
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• 2013

Objective : This case report evaluated the effect of Saengkangsasim-tang(生薑瀉心湯) on allergic rhinitis. Methods : Two different patients of allergic rhinitis were treated with Saengkangsasim-tang (生薑瀉心湯) in accordance with diagnostic system based on Shanghanlun(傷寒論) six meridian patterns and provisions. Results : After a series of Saengkangsasim-tang treatments, the symptoms of allergic rhinitis patients improved in 2 cases. Conclusions : According to diagnostic system based on Shanghanlun(傷寒論) six meridian patterns and provisions, this case study shows that Saengkangsasim-tang is effective on allergic rhinitis. However further clinical studies in depth are needed.

• Journal of Korean Academy of Nursing
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• v.37 no.1
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• pp.52-63
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• 2007

Purpose: Effective communication is an essential aspect of nursing care. This qualitative study was performed to analyze nurse-patient conversations about medication. Method: The nurse-patient dialogue was collected by video tape recording during the nurse's duty time in an internal medicine ward. One hundred seventy-eight episodes were extracted from the conversation. Using conversational analysis, the functional phases and patterns of dialogue sequence pertaining to medication were analyzed. Results: Conversations about medication were very brief dialogues, so 68.8% of the dialogue had a duration of less than 20 seconds. However, it was a systematic and comprehensive dialogue which had structures and sequential dialogue patterns. Four functional phases were explored. greeting, identifying the patient, medicating, finishing. The medicating phase was essential, in which the nurse gave the drug to the patient and provided information initiated by the nurse simultaneously. The patterns of the dialogue sequence represented were the nurse provided information first, and then, patients responded to the nurse as accepting, rejecting, raising an objection, or asking again later. Conclusion: As the results of this study show, a nurse's role is important as an educator. For effective conversation about medication, the development of an educational program should be considered, which includes knowledge about medication and communication skills.

• Journal of Korean Academy of Nursing
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• v.40 no.1
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• pp.99-109
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• 2010

Purpose: The purpose of this study was to identify effective nurse interaction patterns with patients in the emergency department. Methods: For this study, video technology was used to record complete conversations between the nurse and patient. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data were collected from November, 2002 to April, 2003. The video recordings were observed for 4 hr for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS). The data were analyzed using cluster analysis to identify the patterns of nurse-patient interaction. Results: Cluster analysis revealed 4 distinct nurse interaction patterns; 1) "closed" characterized by orientation and negative talk, 2) "positive" characterized by positive affective talk, 3) "informative and directing" characterized by task-focused behavior including data gathering, and giving information about medical condition and treatment, 4) "facilitative" characterized by balance of psychosocial and biomedical topics. Patient satisfaction was highest in the facilitative interaction pattern. Conclusion: The patient centered interaction pattern, balancing information exchange and psychosocial exchange are the most effective interactions in the emergency department, suggesting that effective interaction skill is a core clinical nursing intervention in acute care.

• Journal of Korean Academy of Nursing
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• v.39 no.2
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• pp.166-176
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• 2009

Purpose: The purpose of the study was to identify functional structure and patterns of dialogue sequence in conversations between elderly patients with dementia and nurses in a long-term care facility. Methods: Conversation analysis was used to analyze the data which were collected using video-camera to capture non-verbal as well as verbal behaviors. Data collection was done during February 2005. Results: Introduction, assessment, intervention, and closing phases were identified as functional structure. Essential parts of the conversation were the assessment and intervention phases. In the assessment phase three sequential patterns of nurse-initiated dialogue and four sequential patterns of patient-initiated dialogue were identified. Also four sequential patterns were identified in nurse-initiated and three in patient-initiated dialogues in the intervention phase. In general, "ask question", "advise", and "directive" were the most frequently used utterance by nurses in nurse-initiated dialogue, indicating nurses' domination of the conversation. At the same time, "ask back", "refute", "escape", or "false promise" were used often by nurses to discourage patients from talking when patients were raising questions or demanding. Conclusion: It is important for nurses to encourage patient-initiated dialogue to counterbalance nurse-dominated conversation which results from imbalance between nurses and patients in terms of knowledge and task in healthcare institutions for elders.