• 제목/요약/키워드: health care center

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호스피스케어와 전통적 의료서비스 이용간의 사망전 의료비용 비교 (Comparison of Medical Care Cost between Hospice Care and Conventional Care in the Last Year of life)

  • 최귀선;유창훈;이경희;김창엽;허대석;윤영호
    • 보건행정학회지
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    • 제15권2호
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    • pp.1-15
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    • 2005
  • The aim of this study was to compare medical cost of hospice care and that of conventional care during the last year of life, and identify factors that influenced the cost. From January to August 2003 592 terminal cancer patients receiving care from 5 hospice care units and 2 hospice care teams in general hospitals were enrolled to case group. Two hundreds and seventy two terminal cancer patients receiving conventional care from 7 general hospitals were enrolled to hospital-based control group, and 1,636 terminal cancer patients from 122 general hospitals located in same regions with the 7 hospitals were enrolled to community-based control. We used characteristics and medical cost from data of National Health Insurance Cooperation. Total medical cost per beneficiary in cases was about 10 millions won, 14.5 millions in hospital-based controls and 11.1 millions in community-based controls. The hospice care saved $45\%$ over the last year of life compared with hospital-based controls (p<0.0001). Saving of inpatient cost account for approximately $80\%$ of saving per beneficiary. Hospice care saved $29\%$ of medical cost per hospitalization day compared with hospital­based controls and $17\%$ compared with community-based controls (p<0.0001). Multiple regression analyses showed that hospice care significantly saved the medical cost. This study suggest that hospice care save medical cost compared with hospital-based control and community-based control. Most of saving of inpatient cost account for approximately $80\%$ of saving of medical cost.

산후조리원의 산모의 신생아 돌보기 교육 요구도와 교육 만족도 (The Educational Needs and Satisfactory about Infant Care of the Mothers in the Post-partum Care Center)

  • 조결자;정연;백승남
    • Child Health Nursing Research
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    • 제6권3호
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    • pp.344-353
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    • 2000
  • This study was designed to compare the educational needs and satisfactory about infant care of the mothers in the Post-partum Care Center for development of the educational program. The subjects for this study were 100 mothers in the Post-partum Care Center in Seoul and Buchon. The data were collected during the period from Feb. to March, 2000. The Educational Need and satisfactory for Infant Care was measured by questionnaire that has developed by researchers. The data were analysed by descriptive statistics, paired t-test using SPSS PC+ WIN. The results were as fellow; 1) The educational needs of the mothers in the Post-partum Care Center were high (mean=4.32). 2) The satisfactory of the mothers in the Post-partum Care Center of educational program of infant care were middle range (mean=3.60). 3) The educational needs of infant cares in the Post-partum Care Center were higher than satisfactory of the mothers in the Post-partum Care Center of educational program of infant care(t=7.71 p=.000). 4) The educational need by content was signs, symptoms and management of disorders(i.g. cyanosis, seizure, fever, etc.) were higher than general care of baby(i.g. feeding, diaper change etc.). In conclusion, when the infant caregiver in the Post-partum Care Center teaching the method of infant care to mother, there should be in consideration of educational need of mother. And its educational contents must be included of mental and emotional development and signs, symptoms and management of disorders.

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유료 노인 낮보호 시설 모형개발에 관한 연구 (A Study on the Fee-Based Model Development of Day Care Centers for the Elderly)

  • 정신숙;정연강
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.5-18
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    • 1999
  • The aim of this study is the development of a fee - based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi -purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.

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도농복합지역 재가복지대상자의 기능상태평가 (Functional Status Evaluation of Disabled Persons in Urban and Rural Areas)

  • 문미승
    • 한국농촌간호학회지
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    • 제2권2호
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    • pp.127-132
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    • 2007
  • Purpose: The purpose of this study was to provide the basic techniques in utilizing the systematic home-rehabilitation service with a Minimum Data Set for Home Care (MDS-HC) 2.0 navigator system. Methods: The present study was conducted with 50 persons receiving home-care services from a Welfare Center. Respondents were selected from urban and rural areas in and around the Wonju area. Results: The results showed that MDS-HC2.0 was useful to evaluate the functional status of disabled persons in the fields of health and home-care services. Furthermore, this navigator system provided basic information about the functional health problems of respondents and therefore can provide guidance for health and home care services for disabled persons. Conclusions: Through the present study, a comprehensive model for health and home-rehabilitation was developed. The author believes that respondents will have the satisfaction of high quality service if the developed model is used as the standard in planning and providing home-rehabilitation services.

Perioperative Comprehensive Supportive Care Interventions for Chinese Patients with Esophageal Carcinoma: a Prospective Study

  • Zhang, Xiao-Dan;Zhao, Qing-Yu;Fang, Yi;Chen, Guan-Xuan;Zhang, Hui-Fang;Zhang, Wen-Xiao;Yang, Xiao-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7359-7366
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    • 2013
  • Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.

인천광역시 일 보건소 대도시 방문보건사업의 평가 연구 (Evaluation Study of Home Health Care Program Operated in G Public Health Center)

  • 김명순;김영숙
    • 지역사회간호학회지
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    • 제15권4호
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    • pp.539-550
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    • 2004
  • Purpose: The purpose of this study was to evaluate the achievements of the project, and also to find out its strengths and weaknesses. Method: This evaluative study employed system theory and analytic techniques by using criteria which were relevance, appropriateness, adequacy, progress, effectiveness and satisfaction for input, process, output, and outcome of program. Study subjects were participants in the home health care program implemented in G public health center in Inchon metropolitan city in 2003. Results: Input factors including recruitment personnel, and support organization development were not adequately met for the program. However. the goal and objectives of the project were really appropriate for the community needs as well as government's policy. For the Process evaluation, home health care record form and computer data base had not progressed as scheduled, but overall program activities were finished on time. However, cooperation between organizations in the health center during service activity were not supportive. Managerial ability of program charged personnel about coordination and integration of team members was not affirmative. Output and outcome evaluation showed that people improved self care ability were 221 (17.5%). and 71 (5.62%) of subjects were moved into category of possible self-care. Client's satisfaction for this project showed a high degree. Conclusions: Based on the above results support organization and staff personnel for this program should be developed. Also, a community network of resources should be established and case management services should be focused continuously in community based home health care.

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립스틱에서 DSC를 이용한 최대결합수량에 관한 연구 (Studies on the Maximum Bound Water Content by the Differential Scanning Calorimetry on Lipstick)

  • 최기환;안명진;손홍하;김경섭;이상민;정지희
    • 대한화장품학회지
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    • 제38권3호
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    • pp.197-200
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    • 2012
  • 보습제 베이스를 립스틱에 사용하여 보습효과가 우수한 제품개발에 응용하고자 DSC에 의한 결합수형성능, 수분보유능을 고찰하였다. 보습제 베이스를 배제한 견본에서 결합수 형성능은 5.12 %임을 알았다. 보습제 베이스함량에 따른 결합수형성능을 측정한 결과 보습제 베이스 함량이 증가함에 따라 결합수 형성능이 비례적으로 증가함을 DSC측정결과 알았다. 한편 DSC측정결과와 in vitro 수분보유능 측정법을 비교 실험한 결과 유사한 경향을 나타냄을 알 수 있었다. 따라서 DSC에 의한 결합수 형성능 측정법은 앞으로 립스틱 제품의 보습효과를 예측 하는데 유용한 방법으로 생각되었다.

Prenatal diagnosis by direct DNA analysis in facioscapulohumeral muscular dystrophy (FSHD) families

  • Choi, Soo-Kyung;Lee, Je-Hyeon;Kim, Bong-Yoon;Kim, Hyung-Goo;Cho, Eun-Hee;Ryu, Hyun-Mee;Kim, Young-Joe
    • Journal of Genetic Medicine
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    • 제2권1호
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    • pp.23-26
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    • 1998
  • Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant neuromuscular disorder which has been clinically shown to cause progressive weakness and result in atrophy of the facial muscles, shoulder girdle and upper arm muscles. The responsible gene for the FSHD has been located on chromosome 4q35-qter. The probes p13E-11 and pFR-1 detect DNA rearrangements associated with FSHD as under 28 kb DNA fragment in genomic southern analysis digested with EcoRI and the fragment contains 3.3 kb Kpn I tandem repeats. In this study, 4 fetuses with a family history of FSHD were analysed by genomic southern hybridization analysis with probes to determine whether they carried the deleted region. Of the 4 fetuses, three of them had mothers who were FSHD patients and the other one had a father affected with FSHD. After 10-11 weeks of gestation, we performed chorionic villi sampling and extracted DNA from uncultured and cultured tissue cells for the direct DNA analysis. The result of the southern analysis showed two fetuses having received about 15-18 kb of deleted genes from the father and the mother respectively, and found to be FSHD patients. The other two fetuses were shown to have two normal alleles from the parents and found to be normal. Two pregnancies which were determined to be normal were carried to term delivering two healthy babies.

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쉼터거주자의 건강관리실태 및 대안 (Health Status and Health Care System of Homeless Shelter Residents)

  • 한영란;윤희상
    • 한국보건간호학회지
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    • 제28권3호
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    • pp.536-552
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    • 2014
  • Purpose: The purpose of this study was to explore how homeless shelter worker and public health nurses perceive health status and health care of homeless shelter residents (HSRs). Methods: Data collected through focus group interviews. In Focus group, in-depth discussions were between 150 to 160 minutes. Data analyzed using Krueger (1998) step analysis. Participants were seven experienced clinical social workers, nurses working homeless shelters, and public health center nurses for dosshouse people. Results: The results were 4 themes and 15 sub-themes: Characteristics of HSRs, perception of health and health problem of HSRs (alcohol related disease, hypertension Diabetics, gastro-intestinal disease, dental disease and infectios disease such as Tuberculosis, musculo-skeletal disease, prostate problem), health care status of HSRs(insufficient health care service, discrimination of medical staff, lack of health care management, low satisfaction community health care services), and the health care proposal of HSRs(nurse in homeless shelter, integrated health care system, understanding of homeless) Conclusion: Based on the findings of this study, health care programs focusing on understanding of HSRs and chronic diseases of HSRs increasing steadily although the management system is limited. Therefore, more systemized health care plan and health referral system for homeless people.

보육시설 영유아 건강관리 현황 (Health Management Status of Day Care Centers)

  • 김희순;라진숙;이혜정;최은경
    • Child Health Nursing Research
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    • 제14권3호
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    • pp.295-304
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    • 2008
  • Purpose: This study was conducted to identify the status of health management and to evaluate the need for health professionals in day care centers in the South Korea. Method: Data were obtained from 360 child care providers in 16 provinces from May to August, 2007. Data was analyzed using SPSS WIN 14.0. Results: Safety education (traffic. 83.8% general safety. 71.6%) was provided more often than the other topic of education. All health related education was provided by child care providers. When minor health problems occurred, the most common management strategy was to send the child home (36.1%). During emergency conditions, majority of child care providers preferred taking the children to medical centers without giving any emergency care and 19.4% reported sending the child home without any immediate care. Child care providers recognized the need for health care professionals. Conclusion: The results of this study suggest the need for services of health professionals in day care centers to satisfy the needs and expectations for health management in these centers. As health professionals, public health nurses or pediatric nurse practitioners may play an important role in health management of children in day care centers.

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