• 의료법학
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• 제9권2호
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• pp.77-107
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• 2008

In Republic of Chaina (Taiwan), Natural Death Act named "Anning Huauhe Yiliao Tiaoli" which means palliative and hospice care act was enacted in year of 2000. And enforced in the same year. Many scholars say that Taiwan's Act took Many U.S.A.'s acts such as 'Federal Patient Self-Determination Act 1990', 'California Natural Death Act 1976' and 'Washington Natural Death Act 1979' for a model. Taiwan's Act adopts a few outstanding systems - 'advance declarations' including 'living will' and 'durable power of attorney for health care', 'family-determination system' for a patient who is in a persistent unconscious state. This paper disusses this Act. 'The content is as follow: 1. A background of legislation. 2. The purpose of legislation. 3. The concept of terms. 4. Patient's self-determination. 5. Subrogated determination by family. 6. Keeping documents. 7. Punitive provision. 8. The relationship with euthanasia. 9. Controversial issues.

• Child Health Nursing Research
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• 제16권4호
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• pp.344-351
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• 2010

Purpose: This study was done to examine effects of a discharge education program using on-line community on parenting stress, baby care confidence for mothers of premature infants and health problem of premature infants. Methods: Using a non-equivalent control group pretest-posttest quasi-experimental design, 32 participants were assigned to an experimental (17) or a control group (15). Mothers in the experimental group were introduced to the discharge education program 2 weeks before the baby was discharged. They participated in the on-line community for 4 weeks after discharge. Parenting Stress Index and Baby Care Confidence Scale were utilized for data collection. Data were analyzed using descriptive statistics, $X^2$-test, Fisher's exact test, and Mann-Whitney U test with the SPSS program 16.0 version. Results: In the experimental group, mean scores for parenting stress were lower than for the control group (Z=-3.176, p=.001), while scores for confidence in baby care were higher than for the control group (Z=-3.195, p=.001). Conclusion: Findings indicate that discharge education programs using on-line community have the positive effect of decreasing parenting stress and increasing baby care confidence for mothers and decreasing health problems for infants. Therefore utilization of the internet and online community to educate parents of premature infants is recommended.

• 융합보안논문지
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• 제13권4호
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• pp.11-17
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• 2013

모든 u-헬스케어 시스템은 보안 취약점을 가지고 있다. 이 취약점은 로컬(local) 또는 네트워크(network) 상에서 잠재적인 위험이 된다. 의료정보 기술의 Smart 환경, Ad-hoc networking, 무선통신 환경은, u-헬스케어 보안 취약성을 증가시키는 주요 요인이다. u-헬스케어 의료정보시스템 도메인은 사용자단말 구간, 공중통신망 인프라구간, 네트워킹구간, 인트라넷구간으로 구분된다. 의료정보시스템 도메인별을 구분하여 취약점을 평가하는 이유는 도메인별로 취약점에 대한 대처방법이 다르기 때문이다. u-헬스케어시스템 5단계의 보안위험도 평가체계는 도메인별 보안취약성 진단체계를 설계하여 보안대책을 강구하기 위해 필요하다. 제안하는 모델을 사용할 경우 현재까지 막연하게 진행 되어온 USN 기반 의료정보네트워크 보안취약성 진단대책을 좀 더 체계적으로 수행할 수 있는 모형을 제공한다.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2007년도 심포지엄 논문집 정보 및 제어부문
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• pp.436-438
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• 2007

As the sensors and communication technology get advance, the remote health diagnosis for patients and senior persons at home are possible now without visiting doctors in hospitals. A low-power ubiquitous health check device was developed adapting Real-Time Embedded Linux is developed. This ubiquitous device is consisted of three sensors. The wrist type health checking terminal acquires periodically the health data by using a blood pressure sensor, a pulse sensor and a body temperature sensor. It transmits the health data to the access point located at the home center through the ZigBee wireless communication modem. This health data collector or access point device sends the data again to the main server operated in a hospital or health care organization. The health server control continuously the input data and sends an alarm signal to the assigned. doctor and responsible persons using cellular SMS when any dangerous events occur. This wrist type health check device has an embedded linux OS using Intel PAX255 MPU. The developed U-Health system is applicable for checking patients health in remote at home. And their family or related persons in remote site can check the patients health status at any time. They can be assured by receiving SMS record and alarm of emergency case which is transmitted from the health server.

• Journal of Preventive Medicine and Public Health
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• 제26권2호
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• pp.293-309
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• 1993

With expanded and extended coverage of the national medical insurance and fast growing health care expenditures, appropriateness of health service utilization and quality of care are concerns of both health care providers and insurers as well as patients. An accurate patient classification system is a basic tool for effective health care policies and efficient health services management. A classification system applicable to Korean medical information-Korean Diagnosis Related Groups (K-DRGs)-was developed based on the U.S. Refined DRGs, and the performance of the developed system was assessed in this study. In the process of the development, first the Korean coding systems for diagnoses and procedures were converted to the systems used in the definition of the U.S. Refined DRGs using the mapping tables formulated by physician panels. Then physician panels reviewed the group definition, and identified medical practice patterns different in two countries. The definition was modified for the differences in K-DRGs. The process resulted in 1,199 groups in the system. Several groups in Refined DRGs could not be differentiated in K-DRGs due to insufficient medical information, and several groups could not be defined due to procedures which were not practiced in Korea. However, the classification structure of Refined DRGs was retained in K-DRGs. The developed system was evaluated fur its performance in explaining variations in resource use as measured by charges and length of stay(LOS), for both all and non-extreme discharges. The data base used in this evaluation included 373,322 discharges which was a random sample of discharges reviewed and payed by the medical insurance during the five-month period from September 1990. The proportion of variance in resource use which was reduced by classifying patients into K-DRGs-r-square-was comparable to the performance of the U.S. Refined DRGs: .39 for charges and .25 for LOS for all discharges, and .53 for charges and .31 for LOS for non-extreme discharges. Another measure analyzed to assess the performance was the coefficient of variation of charges within individual K-DRGs. A total of 966 K-DRGs (87.7%) showed a coefficient below 100%, and the highest coefficient among K-DRGs with more than 30 discharges was 159%.

• 지역사회간호학회지
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• 제33권4호
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• pp.372-384
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• 2022

Purpose: The aim of this study was to investigate the educational status and needs of premature birth prevention, and to identify factors associated with preconception health behaviors. Methods: The study design was a crosssectional descriptive study. Data were collected through an online questionnaire survey, and the subjects were 192 women of childbearing age in Korea. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis test, Spearman's correlation coefficients, and multiple regression. Results: The proportion of subjects who received education on premature birth prevention was 8.9%, and 75.5% of subjects answered that they needed education on premature birth prevention. They demanded education through online media, small groups, cases, cartoons (webtoon) with stories, pictures, and videos. A related factor of preconception health behavior was self-efficacy for high-risk pregnancy health care (β=.20, p=.012), which accounted for 8.2% of the total variance related to preconception health behavior. Conclusion: There was a need for more development of education programs to prevent premature birth for women of childbearing age. Its education programs should be applied with online, small group activities using various educational media. It is also required to promote preconception health behavior through self-efficacy for high-risk pregnancy health care.

• 대한간호
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• 제33권1호
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• pp.80-91
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• 1994

This study was done to gather the basic information needed to identify how the home nursing care needs and implementation of self care is being carried out for chronically ill patients. The subjects of the study were 294 from chronically ill patients in a general hospital, a university hospital and seven primary health care center and the data was collected by a nurses, public health nurse practioners using questionairs from July 30 to September 30, 1993. The data were analyzed using percentage, mean, and T-test, ANOVA. Our objectives were to understand basic nursing information general characteristics, implementation of self care, home nursing care needs, implementation of self care depend on general characteristics. The results of the study were as follows 1) General characteristics of subjects. The majority of subjects are female (54.8%) 66.7% of residence are fishing and agrarian villages. 20.1% of disease are neurologic system (backache, neuralgia, HIVD, C.V.A). 2) Evnironmental offord reveals high point in implementation of self care.($2.76{\pm}1.37$) 3) B.P check reveals high peroentage in home nursing care needs.(84.7%) 4) Implementation of self care depend on general characteristics reveals significantly different by $sex^{*}$, educational $level^{**}$, monthly $income^{**}$, number of $family^*$,{\;}$disease^*$, and reason of $untreatment^{**}(^*<0.05,{\;}^{**}<0.01)$. In conclusion the study requires efforts of nurse practitioners, and the support of useful resouress by government.

• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2007년도 추계학술발표대회
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• pp.801-804
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• 2007

실 시간적인 데이터의 수집과 더불어 수집한 데이터의 실 시간적인 전송을 기반으로 정보를 보다 폭넓게 활용할 수 있는 환경을 제공하기 위해 시스템에서 자동적으로 정보를 배포해주는 Publish/Subscribe 시스템에 대한 요구가 증대되고 있다. 이러한 pub/sub 시스템은 사용자의 요구사항을 미리 저장, 이를 이용하여 수집되는 정보와 사용자의 요구와 사용자를 찾아 배포해주는 방법을 사용하는데, 이때, 일치 여부를 확인하는 매칭 과정에서의 많은 자원과 시간의 소모가 문제점으로 대두되고 있다. 따라서, 논문에서는 보다 효율적으로 데이터와 범위를 이용하여 나타내는 사용자의 요구를 매칭하는 방법을 제공하는 CGIM 알고리즘을 제안하였다.

• 한국IT서비스학회지
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• 제7권2호
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• pp.113-125
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• 2008

To test if the developed ubiquitous health care devices working well and vital information could be collected and monitored systematically through internet and to test if the devices and services could be used further. Kyungwon University, KT Co., Gil Medical Center, LIG Nex1 Co., and Sujeong Health Center conducted an ubiquitous health care demonstration project in Sujeong-Gu, Sungnam, Korea from Mar. 5 to May 16. We developed and applied several medical devices to monitor health of the elderly in their houses through internet. The devices were sphygmomanometer, glucometer, body fat scale, Health Pad, and activity sensor. We distributed the devices to 20 recipients of home care and 7 diabetes patients. After received the devices and were explained how to use them, they used the devices in their houses. The vital signs of the residents were monitored through internet. A nurse monitored and consulted their vital signs in the monitoring center in Kyungwon University during the demonstration period. The consultant called them and consulted on their blood pressure, blood sugar level, and body fat after a few seconds they used the devices as well as provision of recommended contents such as diets and activities through Health Pad. To investigate cognition and satisfaction of the participants for the devices, we surveyed the participants at the end of the demonstration period. For the change in blood pressure, blood sugar level, and activities, we conducted statistical test. After the demonstration period. cognition and satisfaction for the devices and change in blood pressure, blood sugar level, and activities were evaluated. Most of the participants were acknowledged how to use the device and satisfied with the use of the devices. The internet monitoring and services are considered to be promising because most of the participants were satisfied especially because somebody was monitoring their health status. However some weaknesses such as short battery life of the activity sensor, lack of connection of consultations with hospitals, and low understanding on usage of some of the devices need to be complemented.

• 한국병원경영학회지
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• 제7권1호
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• pp.105-120
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• 2002

In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.