• 지역사회간호학회지
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• 제10권1호
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

• Child Health Nursing Research
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• 제23권4호
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• pp.407-415
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• 2017

Purpose: The purpose of this study was to examine how child development knowledge, child rearing knowledge, and use of healthcare services after discharge affect maternal confidence among mothers of premature infants. Methods: Participants in this study were 55 mothers who were involved in internet communities for mothers with premature infants and 30 mothers who visited hospitals for follow up care after having their babies discharged from Neonatal Intensive Care Units (NICU) in South Korea. Results: Presence of operation history, child development and rearing knowledge, and use of healthcare service explained 12.2% of maternal confidence. Presence of operation history (${\beta}=.32$, p<.05) and child development knowledge (${\beta}=.52$, p<.05) were significant predictors for maternal confidence. Conclusion: The results of this study suggest that mothers with premature infants need further education especially on motor development, developmental knowledge, and knowledge related to operations for mothers whose child had surgery in the NICU. Also information about services provided from community health services for premature infants need to be advertised and distributed.

• 대한물리치료과학회지
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• 제21권1호
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• pp.45-52
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• 2014

Purpose : This study is to research about the need of a home visiting physical therapy for children with disabilities. Methods : We surveyed the guardians related to it and one hundred and three questionnaires of one hundred and twenty were returned and analyzed. The results are listed below. Results : First, there are many opinions that a need of physical therapy is necessary, but many people suffer from financial problem to use this service. Second, most of opinions using a home visiting physical therapy of children with disabilities are positive. People who need this service prefer it to manage by national public organization. They also want physical therapists who have worked more than five years to treat them and one hour for treatment time required with about twenty thousand won and At last, in the survey, people ranked solving the inconvenience of coming and going hospitals as a highest expectation and avoiding discharge by force due to long-term hospitalization as a lowest one. Conclusion : To sum it up, high demand and expectation of effectiveness of a home visiting physical therapy for children with disabilities mean that study and analysis are essential to establish this system through implementation on a trial basis within a certain period of time for verifying the effectiveness of this service.

• 보건의료산업학회지
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• 제10권1호
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• pp.39-51
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• 2016

Objectives : This study investigated the health care utilization patterns of workers' compensation insurance(WCI) pneumoconiosis patients with excessively long hospital stays. Methods : The discharge summary data of 3,094 WCI pneumoconiosis patients were analyzed. The study sample was divided into 3 groups based on the length of stay(LOS). Health care utilization patterns were compared among the groups with logistic regression analysis, and the LOS determinants were identified with linear regression analysis. Results : The average LOS of the 222 long stay group patients was 1,448 days. Patients in this group tended to use private general hospitals, were admitted through the emergency room and discharged without the consent of a doctor. Conclusions : Many of the long LOS patients will maintain their inpatient status for the rest of their lives. For quality of life and efficient use of health care resources, policy makers need to establish a policy that enables patients to receive outpatient care in appropriate living conditions outside the hospital.

• 한국콘텐츠학회논문지
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• 제18권9호
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• pp.399-410
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• 2018

본 연구는 일 지역공공의료기관을 대상으로 영국 디자인 카운슬의 서비스디자인 프로세스를 적용하여 고객경험기반의 결핵관리서비스를 디자인한 방법론적 연구이다. 본 연구는 환자를 포함한 결핵관리 일선에서 근무하는 직원들의 경험에 기반하여 결핵관리 문제점을 찾고 해결하는 서비스디자인 방법을 활용하여 일지역공공의료기관의 결핵관리서비스를 디자인하였다. 연구범위는 환자 내원 시점부터 퇴원 후 지역사회 연계까지로 서비스디자인을 위해 결핵진료와 관련된 이해관계자 12인으로 팀을 구성하고, 발견하기, 정의하기, 발전하기 및 전달하기의 4단계 과정을 거쳤다. 고객경험기반 결핵관리서비스는 환자가 병원에 내원한 순간부터 퇴원 후 지역사회 연계까지의 과정에 대하여 총 8개 항목 서비스를 포함하여 디자인되었다. 본 연구결과 서비스디자인 방법론은 환자를 포함한 다양한 이해관계자의 총체적인 맥락을 고려한 결핵관리 프로그램 개발에 매우 효과적이었다. 따라서 고객의 경험을 들여다보고 숨겨진 욕구를 찾아 최상의 만족을 제공하고, 이해관계자간 업무효율화의 실현이 필요한 다양한 건강관리서비스 프로그램 개발에 서비스디자인 방법을 활용해 볼 것을 제안한다.

• 대한물리의학회지
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• 제11권3호
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• pp.19-34
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• 2016

PURPOSE: This study seeks to examine the awareness and need of home visiting physical therapy among physical therapist in Gwangju and Jeonnam province. METHODS: Survey was conducted during the continuing education on physical therapist held in Gwangju in 2015 with 297 participants. The survey questionnaire consisted of 12 questions on the characteristics of physical therapists, 8 questions regarding the awareness of home visiting physical therapy, and 7 questions on need. RESULTS: Significant differences were found regarding service period, according to categories of the inconvenience associated with commuting to/from hospitals, long-term treatment for patients, high quality treatment with intensive care, treatment at a time of patients' choosing. The category of hospital fees reduced due to early discharge from the hospital also saw significant differences, depending on respondents' marital status, dependent family, and service period. Providing treatment without causing discomfort to patients in front of others also saw significant differences according to physical therapist career period. Home visiting physical therapy is easier for family members to take care of patients also saw significant differences according to education and physical therapist career period. CONCLUSION: Survey indicates that physical therapist province feel the need for home visiting physical therapy in many respects. However, since as many as half of the surveyed physical therapists have only heard of home visiting physical therapy or are have no awareness of the this form of treatment, it appears that there is a need to raise awareness of home visiting physical therapy among physical therapist and introduce appropriate policies.

• 전기학회논문지
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• 제63권8호
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• pp.1134-1139
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• 2014

Recently the need for renewable energy development is expanding due to the global climate change, the environmental issues and the limited fossil energy resources. Dependence of energy on overseas is high in Korea. To resolve the environmental problems and to improve the energy independence rate, the development of renewable energy is more required. The small hydro power, one of the renewable energy resources, has been developing and operating from a long time ago. If we are new developing a small hydro power with the use existing dams and reservoirs, we will design the length of inlet pipe and the diameter suitable for it. However, in case of using the existing water supply pipe which had been designed suitable for water service, the designer has to review and check that the pipe is suitable for operating a generator. In this paper, the design of small hydro power using the existing long pipe of water supply, we suggest the optimum way to reduce the water hammer in pipe which causes the unsteady flow during the load-shutdown of generator, the generator operation plan for the stable supply of water and the design factor of determining the generator capacity through the analysis between discharge and head-loss.

• 임상간호연구
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• 제17권2호
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• pp.228-238
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• 2011

Purpose: The purpose of this study was to investigate parent expectation and satisfaction with respect to pediatric inpatient care and to identify the variables related to parent satisfaction. Methods: The study was conducted in pediatric wards of a tertiary children's hospital in Korea. The participants were 361 parents of children who were inpatients. Data were collected using a structured questionnaire (The Pediatric Family Satisfaction Questionnaire) at the time of discharge. Results: The highest parent expectation domain was medical service. The parents were most satisfied with nursing service and least satisfied with general hospital service and accommodation. The parents expressed lower satisfaction with hospital facilities, equipment, noise, cleanliness, and communication by health care professionals. Parents with younger children reported higher expectation from the complete hospital service and those who had a longer length of stay reported higher expectation from the nursing service. Conclusion: To improve the quality of hospital services, we need to understand parent expectation and improve and provide clear communication. In addition, the general hospital service and accommodation should not be overlooked for improvement.

• 대한간호학회지
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• 제45권5호
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• pp.742-751
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• 2015

Purpose: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. Methods: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Results: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. Conclusion: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

• 한국콘텐츠학회논문지
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• 제22권10호
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• pp.22-38
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• 2022

최근 코로나 19 장기화로 인한 발달장애 시설 임시 폐쇄와 격리 등으로 수요자가 겪는 고통이 심해지고 있으며, 입원 서비스에 대한 정보도 미흡한 상황으로 뚜렷한 해결책이 보이지 않고 있다. 따라서 수요자를 위한 제도적, 심리적 문제를 예방할 수 있는 서비스 체계가 필요하다. 본 연구의 목적은 발달장애 자녀와 보호자를 위해 체계적인 입원 치료 가이드 및 퇴원 후 관리와 올바른 교육을 제공하고자 한다. 국내 서비스 사례분석을 통해 수요자들의 요구와 개선 요소를 도출한 뒤, 더블 다이아몬드 방법론을 활용하여 실수요자들과 함께 Co-creation을 진행하였으며, 입원 전부터 퇴원 후까지 알기 쉬운 치료 여정과 올바른 정보와 소통을 할 수 있는 서비스 콘셉트를 도출하였다. 이에 따른 협업 공유 애플리케이션 서비스를 제안하였으며, 다양한 이해관계자들의 사용성 평가 및 검증을 통하여 서비스의 유용성을 확인하였다. 본 연구 결과가 사용자경험 중심의 발달장애 병동 보조 시스템 개발에 활용되기를 기대한다.