• Title/Summary/Keyword: care policy

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A Study on Estimating the Nursing Cost of Home Hospice Care (가정 호스피스 간호 수가 개발)

  • Lee, Tae-Wha;Sung, Young-Hee;Choe, Wha-Sook;Hwang, Na-Mi;Park, Hee-Ok;Hwang, Moon-Sook;Jang, Ok-Joo
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.2
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    • pp.182-195
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    • 2008
  • Purpose: Hospice care represents all meaningful aspects of physical, mental and economical status of the end stage patients. The purpose of this study was to estimate the cost of home-based hospice care. Method: Fifteen nurses participated in counting an hour for requirement and home visit data of 50 end stage patients were analyzed. The method of to estimate the cost of home-based hospice care was three ways. Result: In case, including traffic expense, Singles fixed fee per visit via direct inquiry was 112,970 won but in case, excluding traffic expenses, was 86,036 won and traffic expenses per visit was 26,934 won. Final cost of home-based hospice care integrated the fixed fee per the needed time for visit and fee-for services. The fixed fee per 30 minutes was 35,251 won and 60 minutes was 46,595 won and 90 minutes was 57,939 won. We included pain management and the management of emergency and bereavement care among fee-for services. Conclusion: The cost of hospice care should be establish for not only patient but the living spouse, families, and children of the dying and for anyone else affected by any patient's death.

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Comparison of Care Cost Among Large Institution, Small Group-home and Independent Living Home for Disabled People (장애인거주시설 유형별 이용자 보호비용(care-cost) 비교)

  • Kang, Hee-seol;Kim, Yong-deug
    • Korean Journal of Social Welfare Studies
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    • no.37
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    • pp.345-368
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    • 2008
  • The purpose of this study is to compare care unit cost among large institutions, small group homes and independent living homes for disabled people. For this purpose, our study adopted cost-analysis method widely being used in the field of accounting. By the analysis on per-person and per-year unit care cost comparison, care cost of large institutions is estimated 15,000 - 20,000 thousands won, small group homes 10,000 - 11,000 thousands won and independent living homes 4,025 thousands won. By this study, discourse of 'larger size means economic efficiency' which is widely supported by politicians and bureaucrats has no grounds in the practice of Korean residential care services. This study is suggesting two folds. Firstly, small and community based homes should be preferred in the future provision policy of residential care homes for disabled people. Secondly, government grants for small community based homes should be increased to the level of amount provided on large institutions.

The Difference in Attitude toward Medical Care between Patients and Physicians (환자와 의사의 의료에 대한 태도 차이 -한 중소도시의 대학병원과 한의과대학 부속 한방병원을 중심으로-)

  • Kang, Myung-Guen;Park, Jong-Ku;Kim, Han-Joong;Sohn, Myong-Sei;Kim, Dal-Rae
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.516-539
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    • 1998
  • The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

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The Working Conditions for Care Workers and Care Quality in Long-Term Care Services (노인장기요양보험제도에서 요양보호사의 근로조건이 서비스 질에 미치는 효과에 관한 연구)

  • Kwon, Hyun Jung;Hong, Kyung Zoon
    • Korean Journal of Social Welfare
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    • v.69 no.1
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    • pp.33-57
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    • 2017
  • This study examines the effect of working conditions for care workers on the care quality in long-term care facilities, particularly the coexisting perspective on publicness and the marketization of Long-term care services in South Korea brings about. Prior studies have not identified a causal relationship between working conditions and the care quality, only explained cause of a low-wage labor market and low productivity of social services. Theoretical relevance of working conditions and service quality on Long-term care in Korea is to view from a integrated care model by Daly and Lewis(2002). A nonproportional stratified sampling procedure was used to consider Long-term care facility's ownership. A merged dataset combining surveys from 248 Long-Term Care facilities and online resources from NHIC administrative was used and analyzed by multiple regression. The analysis results is showed as follows. Overall, organizations with better working conditions, having higher wage, having greater a fringe benefit, being skills development and training are likely to have good care quality in each area. This research shows that the working conditions, rewards and support to care workers of organizational culture in the normative dimension beyond the minimum standard on labor market policy and evaluation system by government regulations have a positive impact on Long-term care quality.

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A Study on the Regional Self-sufficiency for In-patient Care Services (입원의료의 진료권별 자체충족도에 관한 연구)

  • Han, Dal-Sun;Kwon, Soon-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3 s.31
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    • pp.285-295
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    • 1990
  • The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows : 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved mainly by health policy measures. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characterstics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.

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A Survey on the Utilization of Maternity and Child Health Service, and Service Requirement (보건소 모자보건실 서비스 이용실태 및 요구도 조사 연구)

  • Cho, Seong-Min;Kim, Il-Ok
    • Korean Parent-Child Health Journal
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    • v.6 no.1
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    • pp.1-17
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    • 2003
  • Thus, I studied Health services supplied by local health centers and the requirements of the inhabitants visiting the health care facilities. The purpose of this study was to provide basic material for the establishment of Health care policy and the development of health care businesses. The target places for this study were 4 health centers; Chungrang-Gu, Nowon-Gu, Eunpyung-Gu, Songpa-Gu, with 509 mothers who were visiting the Centers. The question items of this study concerned a total of 124 health-related services provided by the Health Centers. The data was collected for a total of 92 days; July 1st~September 30th, 1999. 800 questionaries were distributed and 559 answered, 509 were analyzed finally. The collected data were processed using the SAS program to get mean, standard deviation, percentage. Open questions were made to reveal the opinions of mothers using the health care center. The results were as follows : 1. Among the participants of the study, 49.7% were 25~29 years of age, 84.3% were house wives by current occupation, 56.2% were from 4~6 person households. 52.1 were educated at a high school level, and 43.6% were educated at a collage level. 2. The highest percentage(53.6%) of the users were spontaneous in their utilization of health care center. The major reason for using the Health care center is that it is free to 65.8% of those covered and of low cost to 19.3% of those covered. 3. The satisfaction level of those using the health care center appeared to be generally high. The general average value showed up as $3.027{\pm}0.519$. 4. The level of recognition of the value of the heath care center services was high, particularly in the basic item of diagnoses of pregnancy, particularly in the basic item of diagnoses of pregnancy. However, the satisfaction level of health care education In pregnancy is low at 20~40%. In the meantime, the level of recognition in breast- feeding benefits is high at 76.8%. 5. The rate of realizing health care center's service campaign was generally low at 10~20%. 41.3 of the people knew the advertizing material of the health care centers. 32.4% of the people knew the advertizing material of the health care centers. 32.4% of the people knew the campaign of health care center for importance of breast-feeding benefits. 30.1% of the people knew the campaign for testing congenital mechanism disease. In the meantime about 50% was recognised the health care centers campaign for the importance and time of infants vaccination. 6. The need for enhancement of health care center services was shown to be high as $3.266{\pm}0.676$ as an average, chicken pox vaccination being the most highly requested at $3.565{\pm}0.587.$. 7. Among the open questions, the additional service to be provided were as follows ; increase of campaign of health care center services, furnishing advertizing books in public locations, providing shuttle bus service to the health care centers, extension of desire for preventative injections, rest and play areas for the children of the families serviced, consultation rooms, etc.

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Emergency Health Care Utilization according to Income class (소득계층에 따른 응급의료이용)

  • Choi, Ryoung;Hwang, Byung-Deog
    • Korea Journal of Hospital Management
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    • v.18 no.4
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    • pp.78-96
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    • 2013
  • The purpose of this study is to analyze the emergency health care utilization using status according to income class. The target was the 2011 data out Korea Health Panel's raw data. 2011 data composed of total 17,035 people from total 5,741 households. This study set total 1,101 adults over full-20-years old having used an emergency health care utilization as its analysis target. In order to find out the number of emergency health care utilization use according to income class and the influential factors on emergency health care utilization cost, this study conducted the multiple regression analysis. And in order to more accurately analyze the emergency health care utilization use status depending on the income class and the features of emergency health care utilization use status, this study developed Models. As the result, this study found following findings. First, as the income class was lower, the gender was male, the age was lower, and the user has spouse, the user was not a business owner or a paid worker, the user is a house owner, the emergency medical facility type was a clinic, the means of transportation was others rather than 119 ambulance, the reason visiting emergency medical facility was belonged to others rather than accidents or poisoning, then the number of emergency was increased. Second, as the user was in higher income class, received the health insurance benefits, the using medical facility was general hospital, used 119 ambulance more often, stay days in emergency was shorter, then health care utilization cost was increased. In this study investigating the data out of Korea Health Panel, it was found that while the number of emergency health care utilization use was increased in the lower income class, but the emergency health care utilization cost was increased for higher income class. It is considered that this finding was caused from the facts that lower income class was more often exposed to dangers for physical health, so the number of emergency health care utilization use was increased, but their health care utilization cost was decreased because of their economic burdens against various examinations and their difficulties to pay such costs, comparing to that of higher income class. Therefore, in order to solve unequal problem of emergency health care utilization use between lower and higher income classs, it is required to set suitable solutions like the disease prevention effort by facilitating national health check-up programs, the enhancement of public health services in quantity and quality, the emergency health care utilization securing policy at using medical facilities, the promotional, educational activities about emergency health care utilization delivery system, the enhanced accessibility of emergency health care utilizations and emergency medical facilities.

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A Study on the Emergence of Family-Care worker: Why Families choose to be Care Worker in Korea? (가족요양보호사의 발생에 대한 탐색적 연구: 한국의 노인장기요양보험제도에서 가족은 왜 요양보호사가 되었나?)

  • Yang, Nan Joo
    • 한국사회정책
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    • v.20 no.2
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    • pp.97-129
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    • 2013
  • This study aims to investigate causes of the emergence of so-called 'family-care workers' in the Long-term Care Insurance system in Korea. The LTCI system introduced in 2008 financially support the utilization of formal care services for the eligible elderly with care needs by paying for services of their care workers. Interestingly, 38.4 percent of payments for the in-home services were claimed by family members registered as qualified long-term care workers in 2012. We interviewed ten family care workers in depth and analyzed the needs of the aged and their families to explain the emergence of family care workers. The emergence of family-care workers is an inevitable result of choice by family members who face a dual burden of living and caring; be the additional choice following discharge the duty to support the elderly; be the alternative choice to fulfill unaccepted needs for services. These results suggest the needs for a comprehensive public provision of both income and social service support for the aged and an introduction of financial support for family care complementing the formal care support in the LTCI in Korea.

Child Care Time, and Perceptions of and Satisfaction with Time Use, of Fathers and Mothers in Dual-Income Families with Preschool Children (영유아 자녀를 둔 맞벌이가정 아버지와 어머니의 자녀돌봄시간과 시간사용 인식 및 만족도)

  • Kim, Yookyung
    • Journal of Family Resource Management and Policy Review
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    • v.28 no.2
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    • pp.11-25
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    • 2024
  • The purpose of this study is to compare the child care time, as well as the perceptions of and satisfaction with the time use, of fathers and mothers in dual-income families with preschool children. 444 time use data were gathered from the Statistics Korea Life Time Surveys in 2019. The results of this study are as follows. First, the total child care time of the two parents per family on a working day was 72.1 min on average, and more time was spent on primary care than on developmental care. Second, the father's child care time on a working day was 40.8 min on average, and the mother's time, almost three times more-110.3 min, which show a significant difference. By type of care, the mother's care time was about three times more than that of father for primary care, and about two times more for developmental care. Third, the mother's primary care time differed by household income level, and the primary care time of both fathers and mothers differed according to the number of their working hours weekly. Fourth, both fathers and mothers felt somewhat tired and had a time deficit, but mothers were less satisfied than fathers with the division of household tasks between them. To encourage fathers' voluntary participation in child care, they must be informed of their joint responsibility with their spouse as parents must be emphasized under the term "co-parenting." It is necessary to expand systems that support parental care and promote a family-friendly culture in workplaces to guarantee the rights of parents.