• 농촌의학ㆍ지역보건
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• 제36권4호
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• pp.227-237
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• 2011

농촌지역 재가장애인의 재활서비스 이용실태를 파악하고자 일개 농촌지역 재가장애인(3-6급 뇌 병변 지체장애) 101명을 대상으로 2011년 3월부터 4월까지 면접 조사를 실시하였다. 대상자는 여자가 65.3%였고, 70세 이상이 53.5%로 가장 많았고, 초등졸 이하가 72.3%이었다. 주관적 경제상태는 보통이상이 56.4%, 의료보장형태는 94.1%가 건강보험이었다. 대상자의 장애 및 건강관련 특성으로는 지체장애가 81.2%, 장애등급별은 3-4급이 41.6%로 가장 많았고, 동반 질환이 있는 경우가 74.3%였다. 본인이 생각하는 자신의 장애정도가 '심각하다'고 한 경우가 69.3%였다. 재가장애인의 70.3%는 퇴원 후 현재 재활서비스를 받고 있었다. 이용하지 않는 이유로는 치료의 효과성과 주변 서비스 기관의 부재, 경제적인 측면 등을 이유로 들었다. 재활서비스를 받기 위해 이용하고 있는 기관은 병의원, 재활의학과 병의원, 한의원 보건소 순으로 많았다. 현재 이용하고 있는 재활서비스 내용에 대해 19.7%가 만족한다고 하였고, 불만족의 이유로는 거리가 멀어서가 가장 많았다. 현재 재활서비스 이용여부에 영향을 미치는 유의한 변수로는 성별, 직업유무, 주관적 경제상태, 장애발생 원인이었다. 즉, 여자인 경우, 직업을 가진 경우, 경제상태가 좋은 경우, 장애발생이 후천적인 경우 재활서비스 이용이 높았다. 농촌지역 재가장애인의 70.3%가 현재 재활서비스를 이용하고 있으나 포괄성, 접근성, 지속성, 만족도 등에서 미흡한 것으로 나타났다. 현재 국가차원에서 추진되고 있는 지역사회중심재활사업을 중심으로 농촌지역 재가장애인을 위한 양적 및 질적으로 충분한 재활서비스 제공이 요구되며, 미이용 집단 및 미충족 집단을 우선 사업대상자로 선정하여 서비스를 제공하는 전략이 필요할 것으로 판단된다.

• 한국농촌간호학회지
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• 제2권2호
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• pp.127-132
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• 2007

Purpose: The purpose of this study was to provide the basic techniques in utilizing the systematic home-rehabilitation service with a Minimum Data Set for Home Care (MDS-HC) 2.0 navigator system. Methods: The present study was conducted with 50 persons receiving home-care services from a Welfare Center. Respondents were selected from urban and rural areas in and around the Wonju area. Results: The results showed that MDS-HC2.0 was useful to evaluate the functional status of disabled persons in the fields of health and home-care services. Furthermore, this navigator system provided basic information about the functional health problems of respondents and therefore can provide guidance for health and home care services for disabled persons. Conclusions: Through the present study, a comprehensive model for health and home-rehabilitation was developed. The author believes that respondents will have the satisfaction of high quality service if the developed model is used as the standard in planning and providing home-rehabilitation services.

• 보건행정학회지
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• 제21권2호
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• pp.279-308
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• 2011

Background : Demands have increased for a variety of welfare services and customized services for persons with disabilities(PWD). A management System focused on PWD was needed to provide for comprehensive services. The purpose of this study was to design a disability database and an application system in order to provide continuous and comprehensive rehabilitation service for PWD. Methods : We analyzed local and abroad disability-related policies and systems and derived the contents that should be included in the integrated database for PWD through a survey among rehabilitation specialists. Result : The integrated database for PWD was composed of 7 categories including General Characteristics, Health & Medicine, Assistance, Education, Employment, Economics and Daily & Social Life. The applicable system of integrated database for PWD was proposed to help conducting policies in such areas as follows ; 'welfare', 'education and culture', 'economic activity', 'social participation' and 'Health'. Conclusion : The main goal of disability policy and strategy should be established by systematically analyzing disability-related data integrating database of PWD. Accordingly, specific objectives and directions for disability policies should be set and efficiently managed and operated. The integrated database for PWD may be utilized for disability-related policies and service monitering, sustainable and integrated management and community participation and integration based on the rights of the disabled.

• 융합정보논문지
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• 제9권1호
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• pp.74-85
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• 2019

본 연구에서는 정신질환자 직업재활시설을 중심으로 직업재활서비스가 어떠한지 상황을 파악하고 서비스 개선 전략을 제언하고자 직업재활 시설장들을 대상으로 초점집단인터뷰(FGI)를 실시하였다. 이를 통하여 정신질환자 직업재활시설의 서비스 환경과 관련된 자료를 수집하였고, 이 자료를 분석하여 결과를 도출하였다. 연구결과는 다음과 같다. 첫째, 정신질환자 직업재활서비스를 제공함에 있어서 정신질환자라는 특성만을 고려할 것이 아니라 그들이 처한 다양한 욕구상황을 고려한 종합적 서비스가 제공되어야 한다. 둘째, 정신질환자 직업재활시설은 장애인복지법상 장애인직업재활시설로 인정되지 않고 정신재활시설 규정에 의해 운영되고 있는데, 이러한 규정은 직업재활시설 운영상황과 맞지 않아 어려움을 겪고 있었다. 셋째, 정신질환자 직업재활시설은 시설운영 뿐 아니라 경영적인 측면에서의 지원을 필요로 하였다. 넷째, 현실을 반영하지 않고 체계화되어 있는 않은 법과 제도의 개정의 필요성을 제기하였다. 이러한 연구결과를 토대로, 서비스 환경을 개선을 위한 몇 가지 제언 점을 제시하였다.

• 보건행정학회지
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• 제33권1호
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• pp.40-54
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• 2023

Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, 'rho' values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion: The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.95-102
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• 2010

Purpose: The purpose of this study was to analyze the necessity of home visit rehabilitation therapy by rehabilitation professionals working at social welfare facilities. Methods: The subjects of this study were 227 rehabilitation professionals (social worker, nurse, physical therapist, occupational therapist, speech-language therapist, special education teacher, and staff of institutions for the disabled who were working at community rehabilitation centers. The data were collected over 65 days (2008. 09. 10~11. 14). The results were analysed statistically by the Chi-square test. Results: The results are as follows: Long-term care service was established in Korea by the Ministry of Health in July, 2008. But there are limits to their being able to provide various rehabilitation services for chronic patients and old people. According to a recent survey, almost all rehabilitation professionals (N=227) stated that home visit rehabilitation therapy is necessary. Conclusion: In Korea, the long-term care service has a nursing service and a service supporting physical activities of daily living, but not physical therapy. So, home visit rehabilitation services should include physical therapy, rehabilitation exercise, and pain management.

• 한국임상보건과학회지
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• 제3권3호
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• pp.399-408
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• 2015

Objective. There were two objectives of the study, first was to identify the barriers as perceived by the patients and providers to access the low vision services and second was to identify the challenges faced by the main providers. Study design. Structured questionnaire based interviews of patients and providers Methodology. To find out the barriers to access of low vision services, the interviews based on structured questionnaire were conducted for two patient groups. The first group consisted of 97 visually impaired individuals attending the department of low vision services at Al-Shifa Trust Eye Hospital Rawalpindi while the second group included 56 visually impaired individuals attending the four rehabilitation centers/schools for the blind in Rawalpindi/Islamabad. To identify the barriers as perceived by the main providers of low vision services and challenges faced by them the interviews based on structured questionnaire were conducted for 19 low vision service providers. Results. From patients point of view, major barrier to low vision services identified was inability to visit hospital /rehabilitation center alone - 29.8% in hospital group and 33.9% in rehabilitation centers group, while the lack of social support, lack of family support, cost of travelling, long distance, afford ability, hesitation in using devices and lack of satisfaction were other important barriers identified. From providers' point of view, major barrier to uptake of services was the need for repeated follow-ups. Optometrists were the main provider of low vision services contributing to 47.4% of the providers. The major challenge faced by the providers was motivation of patients to use low vision devices. Conclusion. The major barrier to low vision services according to the patients is inability to visit the hospital alone, while according to providers, it is the need for repeated follow up which proves major barrier towards uptake of services. The motivation is the major challenge faced by providers, majority of which are optometrists.

• 디지털융복합연구
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• 제16권7호
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• pp.19-26
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• 2018

본 연구의 목적은 첫째, 산업재해근로자의 재활서비스 이용실태와 서비스 이용에 대한 욕구가 시간에 따라 어떻게 변하는지 분석하고자 한다. 둘째, 어떤 요인들이 재활서비스 이용 욕구 변화에 영향을 주는지 분석하고 그 결과를 통해 산재근로자를 위한 정책 개선 방향을 제시하는 것이다. 산재보험패널 1~3차 자료 5,004 관측치를 대상으로 STATA를 이용하여 패널회귀분석을 실시하였다. 횡단분석에서 재활서비스 필요정도에 미치는 영향 요인은 연령, 교육연수, 현재 직무수행능력, 지역사회서비스 경험, 재취업, 미취업으로 나타났다. 시간의 변화에 따른 재활서비스 필요정도에 유의미한 영향 요인은 연령, 교육연수, 미취업, 현재 직무수행능력, 지역사회서비스 이용 경험으로 앞의 횡단면 분석과 다르게 나타났다. 따라서 산재근로자의 연령, 학력, 경제활동 형태 등에 따라 재활서비스 내용과 그 필요 정도가 시간에 따라 변한다는 점에서 요양기간 종료 후 초기 개입 내용을 시기별로 점검하고 조정하는 것이 필요할 것이다.

• 한국병원경영학회지
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• 제6권3호
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• 한국보건간호학회지
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• 제17권2호
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• pp.203-211
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• 2003

The purpose of this study was to investigate the degree of satisfaction in using rehabilitation exercise rooms in public health centers. A total of 100 subjects were participated in the study who were clients of rehabilitation exercise rooms in two public health centers in one city of Kyunggi Do, Korea. Data were collected from March 1 to 30, 2003 using questionnaire. The data were analyzed using SPSS/PC computer program. The result are as follows : 1. The mean age of subjects was 62.6 years old, and men constituted $67.0\%$ of the participants. Most participants $(64\%)$ were in the middle socioeconomic status, and $(65\%)$ of subjects was diagnosed as stroke. 2. Regarding the source of information about rehabilitation exercise room in public health center, $56.0\%$ obtain information from colleagues or neighbors, and for most participants the time required to travel to rehabilitation exercise room was less than 30min on foot. Among rehabilitation services, Taping therapy $(53.0\%)$ was most frequently used among participants, 3. Sum of all satisfaction score was $71.10(\pm6.60,\;range:\;1-90)$ showed higher level of satisfaction. Cost, reliability, and kindness were main factors that affect the degree of satisfaction among participants. 4. Twenty-four percent of the respondents utilized clinic services in the health centers, and $27.4\%$ stoped rehabilitation services from hospitals and/or clinics due to high cost. 5. In the use of rehabilitation exercise room was positively correlated to age (r=.214, p<0.05) and disease duration(r=.241. p<0.05).