Journal of The Korea Institute of Healthcare Architecture
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v.6
no.10
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pp.31-40
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2000
Facing the aging society in Korea, the supply of elderly care services has to be increased. Among these services short-stay care service is one of the alternative service connecting home and communities and this service is at the beginning stage in Korea. This paper aims to identify the current status and characteristics of short-stay care facilities in Korea. On the bases of survey and analysis the basic data for architectural planning and design of short-stay care facilities for elderly have been proposed.
Journal of The Korea Institute of Healthcare Architecture
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v.10
no.1
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pp.19-28
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2004
Recently, as the population of the elderly rapidly increases, the number of the special care facility for the elderly is a big social issue. The services for the elderly are divided two way. One is a facility care, the other is an in-home care. In-home care(day care, short stay care, home help) facility for the elderly in seoul are insufficient now. So this study quantitatively estimate In-home care facility needed in seoul in 2007, 2012 and 2017, propose a arrangement of these facility in seoul.
The purpose of this study were to find out the difference of needs of caring between care-givers and non care-givers, and to suggest the way of lessening vigorous task of care-givers for the elderly with dementia. Data were collected from 130 nationwide respondents intentionally divided into two groups; care-givers and non care-givers in the middle aged with middle and upper income. Collected data were analyzed by frequency, percentage, t-test using SPSS package. Since the result of survey, unexpectedly, showed no difference between two groups, it could be explained as that these two groups commonly had same needs of caring for the elderly with dementia. Major findings were as follow; 1) Most Koreans stiff thought family should be the main care-giver for the elderly with dementia prior to nation or society. 2) Responsibility of caring for the elderly with dementia would be better to be shared with children instead of focusing to a child. 3) They thought ideal residential facilities for the elderly with dementia were small-scale professional dementia facility(group home) rather than home or general elderly housing. 4) Professional dementia care hospital was one of the most needed facilities for the elderly with dementia, followed by short-stay and dar-care center. 5) It was revealed care-giving task was vigorous showing that most care-givers spent 1-5 hours a day for caring, while 13% of respondents spent 11-24 hours a duty. 6) 90% of care-givers took the responsibility of main care-giver because of duty of offsprings or spouses, and wanted to be free from their current circumstances. From the result of this survey researchers would like to suggest the establishment of diverse facilities for professional dementia care to lessen the caring burden for the elderly with dementia: group home, chronic hospital, short-stay, day-care center. Financial support from the government for the housing renovation of the caring families should be considered seriously afterward. It is needed to give the opportunity to select proper paid dementia care facilities according to their income and situation of household.
Government provides financial support to the 74 Home help service centers, 36 Day care service centers, and 18 Short stay service centers for the elderly. The number of service centers that receive financial support from the government is far less to meet the potential demand for the community care services. This paper applies cost-benefit analysis to evaluate the net social benefit of the services provided by the 3 types of the community care service centers sponsored by the government to justify the expansion of the government support. The benefit is calculated as community care services are provided privately in the market without financial support from the government. The potential market price is regarded as the benefit or value provided to the elderly. The price levels that potential users are willing to pay for these services are surveyed in the Census for the Elderly by the KIHASA, 1998. The market prices for the community services are generated by equating limited amount of service supply, as in number of users in one year in 3 types of community care service centers, and potential demand for the services. Market prices are multiplied to the number of users of 3 types of community centers to get the total benefit. Total operating cost of the community care service centers is regarded as cost. According to the cost-benefit analysis, Home-help service centers generated net social benefit of 137 billion Won, Day Care service centers generated 15 billion Won, and Short stay service centers generated 6 billion Won. Significant amount of net social benefit indicates that government should increase level of financial support to these service centers.
Aging population is a global trend and Korea is no exception. Due to the progress of the medical and scientific sectors, increase in the average lifetime incurred increase in the number of elderly people. Meanwhile, the family function of supporting the elderly has become a major issue in a society due to the changes in the society's structure and increased entry of the women into the workforce. As a means to substitute the protection of the elderly who are not protected at their respective homes and to replace the tending needs, weekly protection centers and short-stay centers for the elderly were established and operated in Seoul since 1992. However, structured and satisfactory services are not yet to be provided, thus this research intends to understand the current situation at the short-stay centers for the elderly, to identify users' characteristics and to conduct study on nursing need for the health reasons so that the results of the research can be utilized as basic data for the development of nursing care program. Towards this end, this research targeted 142 elderly people who were undergoing treatment at the 11 short-stay centers for the elderly out of total of 13 located in Seoul that were willing to cooperate. The research was conducted from April to May 2002, with the measurement tool developed by Rhee, Seon-ja (2001) to measure the level of nursing need. Then data was collected and analyzed using SPSS program. The results are as follows. The general characteristics of users of the short-stay centers for the elderly were: 123 females $(86.6\%)$, 19 males $(13.4\%)$ and 72 elderly were over the age of 80 $(50.7\%)$. Among these, 24$(16.9\%)$ were living by themselves. Among the illnesses that the subjects were inflicted with were: dementia $(54.2\%)$, stroke $(54.1\%)$ and high blood pressure $(50.7\%)$, in the respective order. Despite the fact that they were diagnosed with illnesses, $47.2\%$ responded that they do not undergo special treatment due to financial reasons. When the level of needs for nursing care among the elderly who use the short-stay centers is divided into informational. physical. and emotional need levels and scored between zero to two, the level of emotional need is the highest with 1.80, followed by physical (1.45) and informational (1.44) need levels. As for the realities of services at the centers and improvement areas, restriction on term was cited as the greatest inconvenience with $38.7\%$, followed by lack of budget (24 respondents, $16.9\%$). Wishful services were financial assistance $(46.5\%)$, medical and nursing services $(40.1\%)$, meal provision service $(8.5\%)$ and counseling service $(4.9\%)$, in the respective order. Based on the above mentioned results, the research identified the need to develop nursing program for the patients of dementia that can be applied onto the short-stay centers and the need to develop volunteer service, backed by societal support. Also, placement of specialized cadre of professionals is needed so that medical and nursing service functions can be provided in a complementary manner.
Background: The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease. Methods: In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed. Results: There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001). Conclusion: In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.
Choi, Jung Hoon;Kim, Ju Ae;Hong, Nam Soon;LEE, Bo Hye;LEE, Eun Hee
Journal of Korean Clinical Nursing Research
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v.19
no.3
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pp.383-394
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2013
Purpose: This study was conducted to investigate the effects of preparatory nursing information and information offering by SMS on anxiety and nursing satisfaction among family members of ICU (Intensive Care Unit) inpatients. It utilized a quasi-experimental research design with a non-equivalent and non-synchronized control group. Methods: The experimental group and the control group were offered a booklet guiding ICU and were offered face-to-face information by nurses using Power Point. The experimental group was additionally offered SMS (short message service) message on patient's safety at night every morning during the hospital stay between 8 and 9 am. All participants in the experimental group and the control group were measured in reference to anxiety at the point of hospitalization and were surveyed anxiety and nursing satisfaction on the third day of hospital stay. Results: The anxiety demonstrated no significant difference between the groups, while the nursing satisfaction was significantly higher in the experimental group than that of the control group. Conclusion: Proving direct information and indirect information via SMS message were considered effective in improving the family member's satisfaction with nursing care. The frequencies of SMS message and the contents of the message and information need to be defined and specified in the given population.
Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.
Background: Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD. Methods: We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into short-term ICU stay (SIS) and long-term ICU stay (LIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared. Results: Fifty-five patients were treated for uncomplicated ATBAD (n=29 for SIS and n=26 for LIS). The incidence of pneumonia (3.6% vs. 7.7%) and delirium (14.3% vs. 34.6%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (SIS: 96.4%, 92.2%, and 75.5% vs. LIS: 96.2%, 88.0%, and 54.2%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events. Conclusion: Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period.
Recently, interest in improving the quality of EMS(emergency medical services) has been increasing. Much effort is being made to innovate the EMS process. The rapid progress of ICT technology has accelerated the automation or intelligence of EMS processes. This study suggests an emergency room management method based on real-time data considering resource utilization optimization, minimization of human error and enhancement of predictability of medical care. Emergency room operation indices - Emergency care index, Short stay index, Human error inducing index, Waiting patience index - are developed. And emergency room operation rules based on these indices are presented. Simulation was performed on a virtual emergency room to verify the effectiveness of the proposed operating rule. Simulation results showed excellent performance in terms of length of stay.
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