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.
The Journal of Korean Academic Society of Nursing Education
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v.12
no.2
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pp.143-150
/
2006
Purpose: The purposes of this study were to identify the actual conditions and needs of the health care utilization and health information in deafs. Methods: Forty-one deaf volunteers were interviewed by suwha nursing students. The semi-structured interviews were conducted in sign language at homes and community centers. The instrument developed by researchers consisted of 22 items including demographic information, health care utilization, and open-ended questions. Data were analyzed using content analysis, frequency and percentage. Results: The most discomfort problems were communication difficulty and expression of symptom. The deaf people wanted to learn about diseases and symptoms. The deaf wanted to get information about cancer. Conclusions: Further studies focusing on educational intervention are needed to increase the knowledge level on disease of deaf. The sign language translators are needed to help communication for deaf in health care facilities.
The purpose of this study is to analyze local-based social welfare facilities to respond to secular change of the UR rental housing estates in Japan. The selected case studies for the analysis are Hibarigaoka, Hamakousien, Turumai UR rental housing estates constructed around 1960's. The analysis was done through UR website, MLIT (Ministry of Land, Infrastructure, Transport and Tourism) and MHLW (Ministry of Health, Labour and Welfare) policy report, and related literature. These case studies are connected with housing policy as well as welfare policy and performed to Stable Living Creation Project by Business Entry System for Stable Living. The types of local-based social welfare facilities are classified by welfare corporation and medical corporation. The results are as follows: 1) The implementation of cooperative and participative system not only the private sector (welfare and medical Corporation, etc.) but also the public (MLIT, MHLW, UR Renaissance Agency, Local government, etc.). 2) Repurposed of land through rent and transfer of land for local-based social welfare facilities in the process of housing stock renewal utilization. 3) The pursue of regional revitalization through attached to multi-generation facility or local community space for elderly in local-based social welfare facilities.
Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.
Journal of The Korea Institute of Healthcare Architecture
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v.29
no.2
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pp.17-26
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2023
Purpose: The purpose of this study is to identify policy implications for the construction of public health facilities in the field of international cooperation, by examining the case of establishing a health care delivery system using a public health center in a rural area of Paraguay. Methods: Firstly, to map the capacity of the 20 public health centers that were studied, we used the WHO Capacity Mapping tool to select and analyze relevant items. Secondly, to assess the utilization of public health centers, we conducted a direct visit survey and analyzed the results using the M-survey tool. Results: The floor plan of each public health center, the structure of the health center, the size of the population served by each health center, the number of monthly visitors, medical human resources, and the budget were classified by health center for comparative analysis. In addition, by utilizing the M-survey tool, we analyzed the general characteristics of the respondents, their perceptions of the purpose and accessibility of public health centers, their satisfaction with using public health centers, and the level of demand for public health centers to play a role in promoting community health. Implications: The results of this study suggest that access to public health facilities for residents in the research area was improved. By classifying public health centers into two types, these centers can perform the functions and roles of primary health facilities. A patient request and evacuation system was established in the research area. Finally, a network, such as a social prescribing program, is needed so that public health centers can function as a "setting" for community members to live together.
Han, Seung Pyo;Kim, Eun Young;Rho, Young Il;Yang, Eun Seok;Park, Sang Kee;Park, Yeong Bong;Moon, Kyung Rye
Clinical and Experimental Pediatrics
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v.45
no.2
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pp.166-173
/
2002
Purpose : The aim of this study is to find out the distribution of illness, patterns of medical care utilization and factors determining medical care utilization in elementary school children. Methods : We performed the questionnaires in Gwangju city on 2,036 children of two elementary schools from June 1 to June 30, 1998. Results : The prevalence rate of illness was 32.3%. The distribution of illness was respiratory disease(64.7%), gastrointestinal disease(12.8%), injury & poisoning. The rate of persons having received medical treatment when they were sick, was 89.8%. The selection distribution among various medical facilities was pediatric hospital(46.7%), otolaryngologic hospital(19.8%), pharmacy (13.2%) and internal medicine in the decreasing frequency sequence. The major factors influencing the selection of medical facility were geographic accessibility and good results. The most common reason for the first visit to the pediatric hospital was geographic accessibility. The most common reason for a visit and to otolaryngologic hospital was a good result. The most frequently utilized medical facility for respiratory symptoms and gastrointestinal symptoms was pediatric hospital. The persons influencing the selection of medical facility in the children were mother(73.3%), father( 10.8%), doctor and others in decreasing sequence. The persons answering the questionaire thought that the optimal age of pediatric care was from 0 to 12 years(47.8%), to 10 years(22.4%) and to 15 years(18.5%) in decreasing rate. Conclusion : Other departments instead of pediatrics have treated children. Children have particular growth and development process, which is different to those of adults. So, it is necessary to choose special medical care and adequate medical facilities for children.
This study was conducted to assess the morbidity and medical facilities utilization patterns of high school students in urban and rural areas, and to contribute to establishment of school health policies. A questionnaire survey was carried out for 1,979 of one boy's and one girl's high school in Pusan and 1,315 of one boy's and one girl's high school in Kyungnam province from March 27 to April 8, 1989. The summarized result is as follows. The number of students who were sick or injured in one month period was 378.0 of 1,000 students. One sick or injured student experienced 1.2 events on the average and thus the incidence rate was 453.2 per 1,000 students for a month. The morbidity rate of the urban area (550.8) was higher than that of the rural area (306.5) while the rate for girl students (561.9) was higher than that of the boy students (328.3) (P<0.01). Especially, the girl students (740.7) in the urban area showed two times higher morbidity rate than that of the girl students in the rural area. Out of all morbidity respiratory disease for 67.6 percent in urban area and 68.5 percent in rural area and it was followed by gastrointestinal disease and nervous & sensory diseases. The morbid conditions took place at school in 37.5 percent, and at home in 59.8 percent. The absence rate due to morbidity was 4.4 percent out of all morbid students. In addition, 73.5 percent of all morbid student utilized medical treatment, of which the pharmacy accounted for 53.8 percent and 57.5 percent in the urban and rural areas, respectively. The second most common facility utilized was hospital OPD. While there was no student who utilized the school nursing room in the rural area, 1.5 percent of the sick students utilized the school nursing room in the urban area. The most important in selecting medical facility was the distance. By low medical expense was more frequent cited reason for selecting medical facility in rural area (13.6 percent) than in urban area (3.2 percent). Mild illness accounted for 70.3 percent of the reasons for no treatment and 21.8 percent was due to the conflict between school hour and clinic hour. The morbid students mostly suffered from mild respiratory and gastrointestinal disease, and its incidence was the highest rate in the school. Although there was relation between the worry of absence and no-treatment, the school nursing room utilization of students was very insufficient. Therefore, it is required to activate the operation of the high school nursing room by utilizing the specialized personnel.
Effects of various factors related to the process of social action of hospital services on the selecting a hospital were investigated by using of questionnaires answered by 1,319 patients in a certain University Hospital, in Chungchongnam-Do, from November, 1986 to November, 1987. The results summarized were as follows ; 1. Each of the examined factors, that is, sincerity of an attendant physician in medical treatment and explaining the condition of a disease, confidence to doctor and nurse, doctor's and nurse's response to calling by patient, kindness of the hospital staffs and food handlers, sanitariness of hospital, cleanness of clothes and bed sheets, hospital foods, and rest surroundings, are not solely decisive to attitude of hospital utilization, but the factors effects compositely on hospital utilization 2. Hospital services of the social action process are more effective to hospital utilization in cases of the hospitalization caused by the traffic facility than for the medical skill and facilities.
Elderly welfare housing refers to a residential facility with diverse medical and welfare services for cohabitation of elderly. Especially, community shared spaces in the elderly welfare housing plays an important role as a place for community and leisure activities that enhance vitality of elderly life. The purpose of this study was to investigate types, planning characteristics and actual utilization of community shared spaces in for-profit elderly welfare housing. Eight for-profit elderly welfare housing facilities in Seoul and Gyeonggi province were selected for this study and categorized into small-, medium- and large-scale facilities based on the number of housing units. Community shared spaces in the elderly welfare housing were classified into six space types: social space, education space, exercise space, medical space, convenience space and leisure space. Findings are as follows. Small-scale elderly welfare housing facilities with less than 100 housing units had fitness centers, clinics, restaurants, convenience stores and hobby rooms which were required by law. All community shared spaces were planned on a single level. Fitness centers was found the most frequently used while the other spaces were not used very frequently. Medium-scale facilities with 100 to 299 housing units had multi-purpose halls, libraries, swimming pools, indoor and/or outdoor driving ranges, physical therapy centers, saunas, karaokes and so on. Most community shared spaces were found frequently used. Large-scale facilities with 300 or more housing units had religion rooms, community halls, hair salons, pharmacies, etc. In most facilities, community shared spaces were planned in distributed locations.
Journal of the Korean Institute of Rural Architecture
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v.23
no.2
/
pp.17-24
/
2021
Changes in the population structure caused by a decrease in the birthrate and an extension of life expectancy cause problems in utilization inefficiencies of closed schools and shortage welfare facilities for the aged. The closed schools have location characteristics that are close to the existing residence and facilities such as land and school buildings, so it is expected that the schools will be used as welfare facilities for the aged in the community. The purpose of this study is to compare and analyze the facility characteristics of closed schools in northern Gyeonggi-Do and present the types of aged welfare facilities that can be built, providing basic data for developing customized aged welfare facilities. The results of this study are summarized as follows: 1) The proportion of aged people in northern Gyeonggi-Do is higher than in southern Gyeonggi-Do, but welfare facilities for the aged are insufficient, so it is necessary to expand welfare facilities for the aged in northern Gyeonggi-Do. 2) Urban areas such as Paju and Goyang City have a lot of residential proximity, Dongducheon and Yangju have a lot of residential proximity, while schools located in urban and rural areas such as Yeoncheon have a lot of residential proximity. 3) Closed schools in urban areas such as Goyang City and Paju City are desirable to use them as residential facilities for senior citizens, day and night protection and short-term protection facilities, while closed schools in Namyangju City, Pocheon City, and Gapyeong County are desirable to use them as senior citizen centers and medical welfare facilities.
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