• 제목/요약/키워드: care-plan

검색결과 925건 처리시간 0.024초

The effect of health care reform: Testing the stability of systematic risk

  • Sewell, Daniel K.;Song, Joon-Jin
    • Journal of the Korean Data and Information Science Society
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    • 제21권5호
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    • pp.945-950
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    • 2010
  • As the U.S. Congress has continued to debate over the health care reform pushed by President Obama, there is an ample reason to believe that the systematic risk of the health care industry, especially health care plan providers, is increasing. This study measures and compares the systematic risk of two health care industry indexes and one portfolio of health care plan providers from before and after the introduction of the health care legislation into Congress in September, 2009. The Capital Asset Pricing Model (CAPM) is used to measure the systematic risk, and a dummy variable approach and the Chow test are used to formally compare the systematic risk from before and after the introduction of the legislation.

일개 지역사회 중심 가정간호사업소의 운영실태 및 운영방안 (A Study on the Operating Status of Community-based Home Health Care Centers)

  • 이은희;박성애
    • 간호행정학회지
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    • 제17권2호
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    • pp.180-188
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    • 2011
  • Purpose: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. Method: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. Results: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. Conclusions: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.

간호업무 전산화를 위한 표준화된 간호계획의 개발에 관한 연구 (A Study on the Development of Standardized Nursing Care Plans for Computerized Nursing Service)

  • 김조자;전춘영;임영신;박지원
    • 대한간호학회지
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    • 제20권3호
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    • pp.368-380
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    • 1990
  • A central issue in the development of nursing practice is to describe the phenomenon with which nursing is concerned. To identify the health problems which can be diagnosed and managed by the nurse is the first step to organize and ensure the development of nursing science. Therefore the academic world has been discussing the application of the nursing diagnosis in nursing practice as a means of improving quality of care. The objectives of this study were to develop a standardized nursing care plan for ten selected nursing diagnoses to form a database for computerized nursing service. The research approach used in the study was (1) the selection of the ten nursing diagnoses which occur most frequently on medical-surgical wards, (2) the development of a standardized nursing care plan for the ten selected nursing diagnoses, (3) application of the plan to hospitalize patients and evaluation of the content validity by the nurses, and (4) evaluation of the clinical effects after the use of the standardized nursing care plans. The subjects were 56 nurses and 395 hospitalized patients on two medical and two surgical unit. The results of this study were as follows ; 1) The ten selected nursing diagnoses for the development of the standardized nursing care plans were “PAIN, SLEEP DISTURBANCE, ALTERED HEALTH MAINTENANCE, ALTERATION IN NUTRITION, ANXIETY, CONSTIPATION, ALTERED PATTERNS OF URINARY ELIMINATION, DISTURBANCE IN BODY IMAGE, POTENTIAL FOR ACTIVITY INTOLERANCE AND ACTIVITY INTOLERANCE”. 2. The developed standardized nursing care plans included the nursing diagnosis, definition, defining characteristics, etiologic or related factors that contribute to the condition, recording pattern, desired outcomes and nursing orders (nursing interventions). 3. The plan was used with hospitalized patients on medical - surgical wards to test for content validity. The patient's satisfaction with the nursing care and nurses' job satisfaction were investigated to evaluate the clinical effects after the use of the standardized nursing care plans. A comparison of patient satisfaction with nursing care before and after the introduction of the standardized nursing care plans showed a statistically significant higher level of satisfaction with the standardized care plans. There was no difference in the level of job satisfaction expressed by the nursing staff before and after the standardized nursing care plans were introduced. However, when opinions about the use of the standardized nursing care plans were examined it was found that there was a positive effect on clarity in defining the nursing problems, determining nursing cost, more feasible goal setting, effective and systematic nursing records and indications for nursing research. The results of this study suggest that in order to increase the use of nursing diagnoses in the clinical area, it would be effective to select some wards as a pilot project, give the nurses training in the use of nursing diagnosis and develop and use the standardized nursing care plans. In addition to the ten diagnosis used in this study it is recommended that continual development of nursing diagnoses be done using diagnoses that are appropriate to Korea and testing them for validity through standardized care plans.

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델파이 기법을 이용한 우리나라 재가간호서비스 연계방안 (Strategies of Home Health Care Services Linkages in Korea Based on Delphi Technique)

  • 이승희;임지영
    • 한국콘텐츠학회논문지
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    • 제12권12호
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    • pp.282-290
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    • 2012
  • 현재 우리나라의 재가간호서비스는 보건소의 맞춤형 방문건강관리사업과 의료기관 가정간호사업, 그리고 노인장기요양보험의 방문간호서비스의 독립성과 전문성을 인정하면서, 각 영역간의 연계를 통해 사업의 중복성을 최소화하는 연계방안이 필요한 상황이다. 이에 본 연구는 재가간호서비스의 연계방안을 도출하기 위해 전문가들의 의견을 바탕으로 합의를 이끌어내는 델파이 기법을 활용하였다. 그 결과 제도적 차원의 연계와 의료적 차원의 연계라는 두 영역 안의 총 24개 항목이 연계방안으로 도출되었다. 재가간호서비스의 연계방안으로 도출된 24개의 항목은 재가간호사업 체계의 개선과 제공되는 서비스 질의 향상, 대상자의 만족도 증대 효과를 가져 올 수 있을 것으로 기대되며, 서비스의 중복을 최소화할 수 있는 방안을 모색함으로서 국가적 차원에서 복지 및 국민 건강관리의 효율성을 증대할 것으로 보인다. 이를 통해 궁극적으로 국민의료비의 절감과 더불어 재가간호서비스 증진에 기여할 것으로 여겨진다.

지역보건의료계획 수립에 있어 지역의료보험자료의 활용가능성 (The Possibility of Regional Health Insurance Data in Blueprinting the Local Community Health Plan)

  • 이상이;김철웅;문옥륜
    • Journal of Preventive Medicine and Public Health
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    • 제30권4호
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    • pp.870-883
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    • 1997
  • The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.

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말기암환자 완화의료정책 현황 (Policy on Hospice and Palliative Care in Korea)

  • 장윤정
    • Journal of Hospice and Palliative Care
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    • 제15권4호
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    • pp.183-187
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    • 2012
  • 말기암환자에 대한 완화의료의 중요성은 세계적으로 강조되고 있다. 이에 우리나라에서는 암정복10개년계획을 수립하면서 암에 대한 정책을 기획하였고, 추진되었다. 말기암환자 완화의료사업에 대한 법적 근거를 제시하는 암관리법과 제2기 암정복10개년 계획의 내용을 통해 현재 우리나라의 호스피스 완화의료 제도화 현황을 확인해보고자 한다. 호스피스 완화의료의 제도화는 국가암관리사업의 커다란 틀 안에서 발전되어 왔다. 완화의료기관의 확대 및 전문인력 양성과 질적 향상 등에 대해 2013년 완화의료 수가 본 사업이 시작된 이후에도 호스피스 완화의료의 지속적인 발전을 위하여 발전해야 할 것이다.

RAI(Resident Assessment Instrument)를 이용한 노인가정간호 및 재가복지서비스 정보시스템 개발 (Development of a Database System for Home Care Service Based on RAI (Resident Assessment Instrument))

  • 전경자;김은영
    • 지역사회간호학회지
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    • 제14권1호
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    • pp.75-82
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    • 2003
  • The purpose of this study was to develop an information system for home care service based on RAI(Resident Assessment Instrument). The standardization of service providing process was conducted using the steps of need assessment, triggers, application of CAPs, and care plan. The structure of MDsoft-HC was composed by MDS-CAPS system and system management system. A database on home care clients was accumulated by putting data, respectively, in general information, MDS-item, and MDS-result. Based on this data, the list of CAPs for the client was selected and monthly and annual statistics were calculated by problem result counts. It was suggested that standardization of a care plan would be integrated and short form of need assessment would be developed in the next stage.

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미혼 및 기혼 무자녀 남성과 여성의 출산 의사 고찰과 미래 예상 출산 자녀수 관련 변인 탐색 (Understanding expected number of children of childless married and single men and women)

  • 권영인
    • 한국생활과학회지
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    • 제23권2호
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    • pp.251-268
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    • 2014
  • Applying the data from 64 single(26 men and 38 women) and 71 childless married men and women(37 men and 34 women) aged between 30 and 45, this study is to understand their future fertility intention. For this purpose, ideal and real number of children that participants plan to have were compared using paired t-test. Second, demographic variables(sex, age, marital status), child care related variables(thoughts about caring children, child care value), individual characteristics(gender role attitude, relation orientation) and social context variables(perceived economic condition, recognition of low fertility policies) were included in a stepwise regression model to explain expected number of children participants plan to have in the future. Results showed that ideal number of children participants wish to have was significantly higher than real number of children they expect to have in the Korean society. The stepwise regression model explained 35% of the variance of the dependent variable. Among four types of variables, child care related variables most powerfully explained expected number of children study participants plan to have in the future. Finally, age, child care value, gender role attitude, and relation orientation significantly explained expected number of children in the future.

노인요양시설의 위험관리시스템 구축활동에서 액션 플랜의 수립과 실행에 따른 성과와 시사점 (Outcome and Implication of Establishment and Practice of Action Plan for the Elderly Care Facility in Establishing Risk Management System)

  • 윤기혁;박경일;권진아
    • 한국콘텐츠학회논문지
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    • 제16권11호
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    • pp.308-320
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    • 2016
  • 본 연구의 목적은 노인요양시설에서 위험의 예방과 대응을 위해 구축한 위험관리시스템의 실제 수행 활동인 액션 플랜의 실행 과정과 성과를 제시하는 경험적 사례 연구이다. 이를 위해 국내 최초로 위험 예방 및 대응을 위해 위험관리시스템을 구축하여 수행 활동을 해온 A노인요양시설이 2년간 실시(2014년~2015년)한 액션 플랜 실행 과정과 성과를 분석하였다. 본 연구의 결과 첫째 위험관리시스템 액션 플랜은 위험관리시스템 구축 4단계 과정 중 세 번째 단계인 위험 예방 및 대응처리 방법의 선택과 수행 단계에서 수립이 되었다. 둘째 위험관리시스템 액션 플랜 실행에 따른 성과로서 2년간(2014년~2015년)의 위험의 변화를 조사를 파악한 결과 2014년에 비해 2015년에 위험이 28% 감소하여 액션 플랜에 수행에 따른 위험관리 활동이 효과가 있는 것으로 나타났다. 이러한 결과를 바탕으로 노인요양시설에서 효과적인 액션 플랜 수립과 실행을 위해 액션 플랜은 독자적으로 수립되는 것이 아니라 비전과 전략을 바탕으로 전략, 성취목표와 성취과제 등이 잘 연계될 수 있도록 체계적인 추진일정을 수립해야 하고, 책임소재를 분명히 해야 하며, 간트 도표 등의 기법을 활용하여 실행되어야 할 모든 내용들이 한눈에 쉽게 알아 볼 수 있도록 도식화하여 구체적으로 작성하는 것이 중요하다.

의사결정나무기법을 활용한 노인장기요양보험 표준급여모형 개발 (A Decision-support System for Care Plan in Long-term Care Insurance)

  • 한은정;이정석;김동건;권진희
    • 응용통계연구
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    • 제27권5호
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    • pp.667-679
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    • 2014
  • 우리나라 노인장기요양보험에서는 수급자가 월 한도액 범위 내에서 필요한 서비스를 비용-효율적으로 이용할 수 있도록 지원하고자 표준장기요양이용계획서를 작성하여 제공하고 있다. 본 연구는 표준장기요양이용계획서의 객관성 확보와 업무 효율성 제고를 위하여 의사결정나무기법을 이용해 수급자의 건강 및 기능 상태에 맞는 최적의 급여계획을 도출하는 표준급여모형을 개발하였다. 타당도 높은 모형 개발을 위하여 국민건강보험공단의 전국 220개 장기요양운영센터로부터 장기요양인정조사와 표준장기요양이용계획서 작성 경험이 풍부한 직원(본 연구에서는 '훈련된 조사자'라고 함)을 추천받아 자료수집의 내용과 방법에 대해 교육을 실시하였고, 이들이 수급자의 건강 및 기능 상태를 평가하고 작성한 수급자 개인별 맞춤형 급여계획을 자료 분석에 활용하였다. 표준급여모형은 1단계로 시설 또는 재가 급여 권고 여부를 결정하는 모형을, 2단계로 재가급여를 권고했을 경우의 재가급여 세부 종류별 권고 여부를 결정하는 모형을 개발하였다. 본 연구에서 개발된 표준급여모형은 전산프로그램화 되어 국민건강보험공단 직원이 수급자에게 제공할 표준장기요양이용계획을 수립하는 과정에 실제로 활용되고 있어 표준장기요양이용계획서의 객관성 확보와 업무 효율화가 기대된다.