• Title/Summary/Keyword: Total cost of nursing activities

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A Study on Hospitalized Patients' Intent to Use Home Care Nursing According to the Types of Medical Security (입원환자의 의료보장형태에 따른 가정간호 이용의사에 대한 연구)

  • Kim, Myung-Hee;Cho, Eun-Ji;Park, Hyoung-Sook;Kang, In-Soon
    • Journal of Home Health Care Nursing
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    • v.12 no.2
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    • pp.63-86
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    • 2005
  • Purpose: This study is a descriptive research which is designed to investigate hospitalized patients' intent to use home care nursing according to the types of medical security. Method: This researcher surveyed 236 patients who were hospitalized at B medical center located in Busan,. Data were collected from Sep. 1 to Nov. 30, 2005 using a questionnaire survey, medical records, face-to-face interviews and observations. Collected data were analyzed in terms of frequency, percentage, mean and standard deviation through $x^2$-test and t-test under SPSS WIN 10.0 Program. Result: Out of the total subjects, 59.3% were medical aid clients and the remaining 40.7%, health insurance ones. The hospitalized period and frequency of the former group were 38.0 days and 4.0 times, respectively, while those of the latter, 37.7 and 3.4. When home care nursing clients were examined using a given classification device, it was found that out of the total 236 subjects, 205(86.9%) were needed to receive home care nursing, 121, medical aid and the other 84, health insurance. 24.0% of medical aid clients heard about home care nursing ever before, lower than 39.3% of health insurance clients. 43.8% of the former clients said cost for home care nursing was high while, 47.6% of the latter group responded expense for the nursing intervention was low. 30.6% of medical aid clients had intent to use home care nursing, lower than 47.6% of health insurance clients. 71.7% of those patients whose monthly income was 99 million won or below had no intent to use home care nursing, higher than 62.5% of those who were 100 million or over in monthly income(p<.05). 76.4% of those clients who had no nursing provider intented to use home care nursing, higher than those who had nursing provider(p<.05). Concerning contents of home care nursing, 85.1% of medical aid clients needed education, training and counseling while, 77.4% of health insurance aids wanted medication and injection. Conclusion: In conclusion, the use of home care nursing by medical aid clients should be promoted through improving conditions for home care nursing in terms of expense, family and residence and making public relations about activities and contents of the home care nursing.

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A Study on Visiting Nurses' Perception of the Service Referral between Health and Welfare (보건 및 복지영역 서비스 연계에 대한 방문간호사의 인식)

  • 정문희;유인영
    • Korean Journal of Health Education and Promotion
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    • v.19 no.2
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    • pp.155-167
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    • 2002
  • This study was carried out to grasp visiting nurses' perception of the service referral between health and welfare with a view to providing the basic data for the visiting nursing activities. A questionnaire survey was conducted on public health nurses in 25 health centers in Seoul from Feb. 12, 2001 to Mar. 15, 2001. A total of 151 questionnaires were collected and they were analysed by use of SPSS/WIN 7.5. The results of the survey are as follows. 1. In general, visiting nurses were burdened with heavy workloads. On average, a visiting nurse covered 5 ‘dong's(the smallest administrative unit), 564 households, and 1223 persons. They spent almost a quarter of their working hours moving from home to home and recording the charts after home visiting. They took 30-60 minutes to provide their services when visiting homes. As for the frequency of home visiting, they were following the instructions recommended by the government. However, their services were still wasteful, not skill-oriented, in that they spent more time assessing ‘subjects’ rather than providing their ‘services’ for them. 2. As for the degree of service performance, visiting nurses scored average 2.94 and 2.28 on the four-point scale in the area of health and welfare respectively. The Pearson coefficient between the two variables was high(.56). According as the health services increased, the welfare services increased as well, which showed that the service referral between the two areas should be essential. 3. ‘The necessity of cooperation with social welfare staff’ scored average 4.49, and ‘the degree of cooperation with social welfare staff’ scored average 3.16 on the five-point scale; There was a statistically significant difference (average 1.33) between the two variables. Such a big difference between perception and practice results from the lack of political support that connects the two service areas comprehensively. Therefore it is recommendable to establish a so-called ‘Visiting Nursing Center’ in the ‘dong’ office in order to provide integrated services of health and welfare at once in cooperation with social welfare staff. That's the way to meet the public needs directly and it's more efficient as well in terms of cost-saving.

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

  • Choi, Mi Young;Chae, Young Moon;Tark, Kwan Chul;Kim, In Suk;Chun, Ja Hae
    • Quality Improvement in Health Care
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    • v.11 no.1
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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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A Study on the analysis of activities of t?e 5.H.T. (5.H.T. in Pusan City) (부산지역 양호교사의 업무분석에 관한 연구)

  • Kim, Lee-Sun;Kim, Bok-Yong
    • Research in Community and Public Health Nursing
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    • v.1 no.1
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    • pp.465-502
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    • 1989
  • The purpose of this study was to find out the general characteristics of school health teachers, the status of school health resources and the degrees of self-confident performance for the 124 school health teachers in Pusan City. Data was collected by means of questionaires from Aug. 1986 to Mar. 1987. The data were analyzed by use of percentage, mean, standard deviation, t-test, ANOVA and Pearson-correlation coefficient. The results of this study were as follows: 1 . General Characteristics of School Health Teachers (SHT) 1) The average of age of the SHT was 32.8 years old and 39.5% of them were from 30 to 34 years old. 2) The average for school nursing experience of the SHT was 7.9 years and 37.9% of them were from 5 to 9 years. 3) The 45.2% of them have not the clinical experience. 4) The 74.2% of them were graduated from the 3 years college of nursing. 2. Status of school health resources and nursing activities. 1) The average of student number was 2497.3 and class number was 45.2. 2) The average of school health budget was 1039000 won and 27.7% of school health budget expended on examination cost. 3) Only 29.0% of all schools have organization for school health. 4) The 84.7% of all schools have health clinic separately and 69.1% of schools have less than $33m^2$ sized. 5) The average of clinic visitor number was 2111.8 for 1 year. 6) Major problem was on digestive system. And other problems were skin, respiratory, musculo-skeletal system and dental problem. 7) The number of literal message was 14.4 times for 1 year. 3. The degree of the school health teachers' self-confidence. The school health teachers' self-confidence was deviced into 6 and the maximum degree was 4. 1) Program planning & evaluation; 2.8 2) Clinic management; 2.9 3) Health education, 3.0 4) Management of school environment; 2.7 5) Health care services; 2.7 6) Operating of school health organization; 2.4 4. Significances to the degree of self-confidence on school health nursing activities. 1) There was significant difference between clinical management and Religion (t=2.15 p<.05) 2) There was significant difference between Operating of school health organization and level of school (F=3.588 p<.05) 3) Program planning & evaluation: expending time for clinical management (r=-0.184 p<.05) expending time for health care services (r=0.273 p<.01) 4) Clinical management: use of separate health clinic (r=0.151 p<.05) 5) Health education: use of separate health clinic (r=0.170 p<0.5) 6) Health care services: No. of student (r=-0.144 p<0.5) No. of class (r=-0.160 p<.05) 5. The degree of the school health teachers' self-discipline. The school health teachers' self-discipline was devided into 2 and the maximum degree was 2. 1) Program planning & evaluation:1.8 2) Clinic management: 1.9 3) Health education: 1.9 4) Management of school environment: 1.7 5) Health care services: 1.8 6) Operating of school health organization.: 1.3 6. Significances to the degree of self-discipline on school health nursing activities 1) Program planning & evaluation; Level of nursing education (F=4.309 p<.01) 2) Clinical management: Level of nursing education (F=3.587 p<.05) 3) Operating of school health organization: School health organization (t=-2.68 p<.01) 4) Health care services: School health organization (t=2,58 p<.05) 5) School health performance: School health organization (t=2.32 p<.05) 6) Program planning & evaluation: School health experience (r=0.239 p<.01) Expending time for program planning & evaluation (r=-0.172 p<.05) 7) Clinic management: School health experience (r=0.249 p<.01) Expending time for dinic management (r=0.181 p<.05) No. of student (r=-0.158 p<.05) Expending time of program planning & evaluation (r=-0.199 p<0.5) 8) Health education: School health experience (r=0.234 p<0.1) Expending time of program planning & evaluation (r=-0.193 p<.05) 9) Management of school environment: Age of school health teacher (r=0.142 p<.05) School health experience (r=0.255 p<.01) 10) Operating of school health organization: Medicine Purchase (r=-0.163 p<.05) 11) Health care services: School health experience (r=0.148 p<.05) Medicine purchase (r=-0.229 p<.01) 12) Total school health performance: School health experience (r=0.200 p<.05) Medicine purchase(r=-0.168 p<.05) Based on the above results, the suggestions are as follows: 1) As the SHT take charge of the reasonable number of student, the students will have benefit of the good health service in quality. 2) It is recommended to use the health clinic separately and to arrange adequate place for good school health service. 3) It is necessary that the SHT participate budget for school health. 4) It is required to enhance self-confidence on school health nursing activities through continuous educational programs.

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A Study on ADL and Dementia of Aged Person with Medicaid in Korea (전국 법정복지대상 노인의 일상생활 수행능력과 치매와의 상관관계)

  • 유호신
    • Journal of Korean Academy of Nursing
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    • v.31 no.1
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    • pp.139-149
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    • 2001
  • The purpose of this study was to analyze characteristics related to the activity of Daily Living (ADL) and dementia among the elderly people who have Medicaid. The cross-sectional descriptive survey study was a nationwide randomization sampling among the population of elderly families who have Medicaid. The data were collected during the month of October, 1999 and total sample was 1,027 elderly people. There were major findings according to the studies. In the results of the ADL assessment most of elderly people were within the 24 to 45 point range. Also, 63.3% of elderly people who made 45 points do not need help when performing daily activities according to the 15 areas of activity components, and 4.9% of these people couldn't do their daily activities. The results of the Dementia assessment were 70.6% of elderly people were in the normal range, 21.7% have a mild case, and 2.8% have severe case of dementia. These were found by using instruments for mental states, which simplified to items of detection of early dementia. In the result of these tests, there was a significantly positive correlation between ADL and degree of dementia with the pearson correlation coefficients. As a result of these studies, the author recommend to strengthen function and organization of public health like a visiting nurse center for elderly people who are over 65 years old. In addition, the government should apply early detection and management system for dementia in the community continuously and cost-effectively, especially for elderly people who live alone and are vulnerable elderly as our priority.

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A Study on a Coping Method of the Family Caregivers of Demented Patients (치매노인 가족부양자의 대처방법에 관한 연구)

  • You, Kwang-Soo
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.648-667
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    • 2002
  • This was a descriptive study designed to identify the level of coping method and its influencing factors on the family caregivers of demented patients, and resolve the family caregivers' level of stress. The data were collected from September 10 to October 10, 2001. Subjects for this study were recruited from four clinics, which were chosen from 15 clinics located in Chunbuk-Do as the study sites because of their cooperation for the study. They were similar in terms of size, the characteristics of the local community. and the population and registration status of the demented patients. The instruments used for the study were as follows: 1. Problematic behaviors of demented patients are measured by the Memory and Behavior Problem Checklist (Zarit, 1980), and the Linguistic Communication Symptoms Questionnaire (Bayles and Tomoeda, 1991) 2. The ability to carry out daily activities was measured using the Barthel Index (1965) and Katz Index (1963), which as well-known ADL assessment methods. 3. Burden was measured using Cost of Care Index by the Kosberg and Cairl (1986). 4. Coping strategy was measured Bell's 18 methods (1977). The data were analyzed using SPSS/PC. The study results were as follows: 1. The total stress score was 2.90 out of a maximum score of 5. The highest score reported was 3.09 on the dimension of restriction of individual and social activities, and the lowest region reported was 2.58 on the dimension of mental and physical health. 2. The total score of the coping method was 2.65 out of a maximum score of 5. The highest score reported was 4.01 on the dimension of thinking that includes an ideation such that it is better than any possible worst case, and the lowest score reported was 1.45 on the dimension of the self-image as a scapegoat. 3. There were significant differences in coping method among the subjects by age (F=2.752 p=0.04), caregiver (F=4.33 p=0.003), care-giving period (F=2.68 p=0.049), and dementia stage (F=2.87 p=0.034). 4. There were highly negative correlations ($\gamma$=-0.301 p=0.000) between problematic behaviors of demented patients and the coping method of their family caregivers. The highest correlation coefficient ($\gamma$=-0.339 p=0.000) was found between aggressive behaviors of the demented patients and the coping method of their family caregivers. 5. There was a low negative correlation ($\gamma$=-0.201 p=0.019) between the ADL of the demented patients and the coping method of their family caregivers. 6. There were highly negative correlations ($\gamma$=-0.213 p=0.005) between stress and the coping method of the family caregivers. The highest correlation was found between financial burden ($\gamma$=-.327 P=.000) and the coping method of the family caregivers. There was no significant correlation among unpleasant aspects of the demented patients, willingness to the demented patients, and the coping method of the family caregivers.

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Employees' Preferences on Various Types of Matching Grants (매칭그랜트 기부방식에 대한 기부자 선호도)

  • Lee, Yeong-Ran;Park, Sang-June
    • Journal of the Korean Operations Research and Management Science Society
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    • v.38 no.1
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    • pp.15-27
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    • 2013
  • Because consumers tend to have negative opinion about a company that neglects social issues like poverty or pollution while it focuses on its own profit, a lot of companies have invested their resources in Corporate Social Responsibility(CSR). CSR has merits of image improving and profit gaining, on the other hand, it has also many shortcomings. First, the cost of CSR may become a heavy financial burden. Specifically, CSR tends to be implemented by a company's unilateral backup, and then this may impose a heavy burden on the company. Second, one cannot expect effects of CSR in a short-term. Because of these shortcomings, the unilateral CSR has gone into alteration of the type of CSR since 1980's. Instead of unilaterality, Cause-Related Marketing(CRM) began to be used for mutual profits among company, consumers, and society. That is, CRM has become to be spotlighted as a new type of CSR. It focuses on partnership between a company and consumers based on cause and mutual profit pursuing through this partnership. So, many contemporary companies prefer CRM activities that derive their positive corporate image, that increase their sales, and that reduce their financial cost. The IBM Matching Grants Program, which is the largest of the IBM-Employee partnership programs, is a typical CRM. This program enables employees and retirees to increase the value of their donations to educational institutions, hospitals, hospices, nursing homes, and cultural & environmental organizations with a matching gift from IBM. Hundreds of educational institutions and thousands of nonprofit organizations have benefited from the contributions by IBM. There might be various types of matching grants. For example, an employee might choose a lump-sum expense or partitioning a lump-sum into a series of small ongoing expenses for his (or her) donation, and a firm might match the employee's total contribution with a lump-sum expense or might match the employee's total contribution with a series of small ongoing expenses. However, it is not easy to find an academic research on which type of matching grant is preferred by employees. This paper shows that an employee prefers the type of matching grants that consists of a lump-sum expense for his (or her) contribution and a series of small ongoing expenses for a firm's contribution [or the type of matching grants that consists of a series of small ongoing expenses for an employee's contribution and a lump-sum expense for a firm's contribution] to the other types of matching grants.