• Quality Improvement in Health Care
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• v.15 no.1
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• pp.55-65
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• 2009

• Health Policy and Management
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• v.2 no.2
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• pp.1-32
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• 1992

The Canadian experience-universal government health insurance administeredby the ten provinces and two territories with some fiscal and policy variations-suggests the possibility of more effectve and efficient health care delivery system. The central purpose of the Canadian health in surance was to reduce and hopefully eliminate financial barriers to medical care. In this it succeeded. But it also produced varous kinds of unexpected side-effects on cost and quality. The Federal and Provincial Governments of Canada continue to exert theri efforts to ameliorate these problems. The lesson from Canada is that the health care revenue should be raised at the national level and managed at the regional level, and the regional healthcare financing organization has to take over the functions of the public health center. These alternatives is expected to make the Korean health care delivery system more efective and efficient, and to achieve health for all. This paper also discussed the policy agenda for implementing such alternatives in Korea.

• The Journal of Korean Medicine
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• v.41 no.3
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• pp.32-54
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• 2020

Objectives: The purpose of this scoping review is to describe the research trends of postpartum healthcare for postpartum women, as well as to identify further direction for research in the area of postpartum healthcare. Methods: This study was conducted sequentially according to the Scoping Review Method referred to as 'frameworks of Arskey and O'Malley'. We searched for articles published as of May 15th, 2020 in seven Korean databases in order to obtain the data. A key term search strategy was employed, including terms such as "Postpartum period care", "Postpartum health", "Postpartum care", and "Postpartum status" to identify relevant studies. Results: Eighty-three articles were selected from a total of 259. The research has been undertaken steadily since 1997, particularly in the fields of Nursing and Korean medicine. In terms of study design, survey studies were the majority (48.2%), followed by interventions and experimental papers (32.5%). However, qualitative research areas are lacking. The research topics were largely divided into two categories: postpartum care characteristics and postpartum care interventions. The characteristics of postpartum care were highly connected with care for mental health. Among the postpartum care interventions, the most common employed was Korean medicine intervention. Conclusion: This study confirms that management of mental health during the postpartum period is necessary. In addition, it is necessary to identify the experiences of postpartum women and the effectiveness of a postpartum care intervention program through the utilization of qualitative research methods. In particular, such research is needed in the field of Korean medicine.

• Research in Community and Public Health Nursing
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• v.30 no.4
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• pp.484-493
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• 2019

Purpose: The purpose of this study was to examine the effect of health literacy and self-care performance on health care utilization of medicaid elderly. Methods: A total of 203 medicaid elderly over 65 and living in B-metropolitan city were interviewed. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and Hierarchical Multiple regression. Results: The average score of the health literacy was 7.88±2.84 out of 12. The average score of self-care was 3.26±0.77 points on the 5 point scale. The frequency of health care utilization by the subjects was 6.65±5.25 a month. The health literacy and self-care performance showed a statistically significant positive correlation. The health literacy and self-care performance showed a statistically significant negative correlation with health care utilization. The factors affecting health care utilization of the subjects were self-care performance, health literacy, and religion, and the explanatory power was 25%. Conclusion: The results indicate that the self-care performance, health literacy, religion are significant factors of health care utilization in medicaid elderly. Therefore, it is necessary to develop strategies to improve their self-care performance and health literacy for reasonable health care utilization. Also, it is necessary to provide the elderly with correct information about medical use from accessible religious institutions, senior community center, and welfare centers.

• Journal of the Korean Data and Information Science Society
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• v.21 no.5
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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.

• Quality Improvement in Health Care
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• v.19 no.2
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• pp.68-80
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• 2013

Background: This study investigates improvements in non-value-added nursing activities in clinical work, in order to improve the efficiency and quality of nursing activities. Methods: The study was performed as a quality improvement project at a tertiary general hospital. The nursing activities that needed improvements were categories into admission care, discharge care, supply management, diagnostic work-up related activities, and others. The nursing time and frequency of non-value-added activities were compared across nine nursing units before and after implementation of the quality improvement program. Post-implementation patient and nurse satisfaction were subsequently analyzed. Result: Post-implementation, the time spent on non-value-added nursing activities was reduced and patients and nurses were satisfied with the improvements. Discussion: Reducing non-value-added activities in nursing can increase the work efficiency and ensure time for patient care, thus improving the quality of nursing care. For further study, accurate surveys on nursing activities based on nursing time are required.

• Journal of Home Health Care Nursing
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• v.27 no.3
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• pp.356-371
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• 2020

Purpose: This study was conducted to assess the working conditions of home health nurses in hospital-based home health institutions nationwide. Methods: A secondary data analysis study was conducted based on the survey data on the working conditions of home health nurses, jointly conducted by the Korean Home Health Care Nurses Association and the Academic Society of Home Health Care Nurses in September 2020. Results: Of the home health nurses respondents, 82.4% worked in tertiary hospitals and general hospitals. Most of the working hours of home health nurses were 40 hours a week. Traffic accidents accounted for a significant proportion of accidents experienced by the home health nurse while performing their duties. Most of welfare and benefits systems applicable to home health institutions were in place. The time allocated to provision of home health nursing services was usually more than 30 minutes but less than 1 hour. The type of position of the individual in charge of home health care differed according to the type of medical institution. Conclusion: It is recommended that continuous investigation and analysis be conducted in order to establish a direction for improvement of home health nurses' working conditions, based on the related accumulated data.

• Journal of Home Health Care Nursing
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• v.30 no.1
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• pp.105-114
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• 2023

Purpose: This study aimed to comprehensively analyze the recent revision of the Outcome and Assessment Information Set (OASIS)-D to version E in the United States to identify the most recent trends in home health care and provide suggestions for implementing home health care in Korea. Methods: This study is a comprehensive literature review. We compared all items in OASIS-D and OASIS-E and identified the most significant changes. Additionally, we have discussed the context in depth. Results: The addition of items related to health literacy and medication reconciliation, strengthening assessment in the cognitive and mood domains, and improving items related to pain assessment were identified. These major revisions resulted from a greater emphasis in the healthcare field on social determinants of health. Additionally, the COVID-19 outbreak highlighted the importance of monitoring and managing the symptoms of home care patients in the community. Conclusion: The key items of the OASIS amendment and their background analysis proposed in this study could serve as a cornerstone for the revision of home health care assessment tools or the development of systematic common assessment tools in Korea.

• Korean Journal of Health Education and Promotion
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• v.29 no.1
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• pp.1-11
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• 2012

Objectives: The nurse visiting health service named Customized Visiting Health Care Program(CVHCP) requires the service innovations incorporating community support into a local service network. The purpose of this study was to assess the community network in CVHCP and inform improvement in this network. Methods: We used Social Network Analysis(SNA) in one CVHCP at H city. Network links were generated by self-administered questionnaires by the 14 community resource centers who quantified their links to all other 25 agents on the list. Links were analyzed by a dichotomous scale for any experience of collaboration and a scored scale of 0 to 3 for level of collaboration using UCINET v6. Results: A list of 14 agents was generated, and local network was dominated by the Public Health Center and a local welfare center named Unlimited Care Center(UCC). According to centrality score, UCC was the most prominent agent, and Public Health Center was the most influential agent, being a link in the pathway flow between other agents for 9.5% of contribution. CVHCP scored lower rank of prominent with 30.8% of other agents reported referring to it. Conclusions: Social network analysis provides a useful network description for informing and evaluation service network improvement in maximizing its service for the CVHCP.

• Tuberculosis and Respiratory Diseases
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• v.84 no.1
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• pp.46-54
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• 2021

Background: The aim of this study was to investigate inhaler device handling in elderly patients. Inhaler devices with respect to misuse and error correction were also compared. Methods: Inhaler use technique was assessed using standardized checklists at the first visit and 3-month follow-up visit after retraining. The primary outcome was difference in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, the most common step of misuse, and factors affecting the accuracy of inhaler use. Results: A total of 251 patients (mean age, 76.4 years) were included. The handling of 320 devices was assessed in the study. All patients had been trained before. However, only 24.7% of them used inhalers correctly. Proportions of acceptable use for Evohaler, Respimat, Turbuhaler, Ellipta, and Breezhaler/Handihaler were 38.7%, 50.0%, 61.4%, 60.8%, and 43.2%, respectively (p=0.026). At the second visit, the acceptable use ratio had increased. There were no significant differences among inhaler types (Evohaler, 63.9%; Respimat, 86.1%; Turbuhaler, 74.3%; Ellipta, 64.6%; and Breezhaler/Handihaler, 65.3% [p=0.129]). In multivariate analysis, body mass index, Turbuhaler, and Ellipta showed positive correlations with acceptable use of inhalers, whereas Chronic Obstructive Pulmonary Disease Assessment Test score showed a negative correlation. Conclusion: Although new inhalers have been developed, the accuracy of inhaler use remains low. Elderly patients showed more errors when using pressurized metered-dose inhalers than using dry powder inhalers and soft-mist inhalers. However, there were no significant differences in misuse among inhaler devices after individual training. Results of this study suggests that repeat training is more important than inhaler type.