• 농촌의학ㆍ지역보건
• /
• 제44권1호
• /
• pp.28-38
• /
• 2019

본 연구에서는 우리나라 보건소 방문건강관리사업과 노인장기요양보험의 방문간호, 의료기관의 가정간호사업 등 가정방문간호사업 현황을 살펴보고, 향후 발전과정을 모색하고자 수행되었다. 본 연구를 위하여 각 가정방문간호사업의 관련 법령, 통계자료, 지침과 안내서, 연구논문과 학술대회 자료집 등을 검색하여 관련 문헌을 고찰하였다. 연구결과 보건소 방문건강관리사업은 지역보건법에 근거하여 주로 취약계층을 대상으로 간호사에게 의해 비용부담 없이 제공되고 있으며, 2017년 12월을 기준으로 1,261,208명 등록 관리되는 것으로 나타났다. 보건소 방문건강관리사업 등록 대상자는 흡연율, 걷기 실천율, 혈압조절율, 혈당조절률 등이 향상되는 것으로 나타나, 건강행위와 질병관리 측면에서 긍정적인 효과가 있고, 비용-편익이 있다고 보고되었다. 노인장기요양보험에서의 방문간호는 노인장기요양보험법에 근거하여 간호사 또는 간호조무사에 의해 재가장기요양기관에서 방문간호를 제공하고 있으며, 시간당 정해진 수가에 따라 비용을 받고 있는데, 2017년에 전체 요양급여비의 0.2%만이 방문간호로 이용하는 것으로 나타났다. 재가장기요양보험 방문간호 이용자는 비이용자에 비해 의료비도 더 적게 쓰고, 입원일도 적다고 보고되었다. 의료기관 가정간호는 의료법에 근거하여 2명 이상의 가정간호사(가정전문간호사)를 고용한 의료기관에서 의사의 처방 하에 가정간호서비스를 제공하는데, 2017년 460명의 가정간호사가 가정간호서비스를 제공하고, 전체 의료비의 0.038%가 가정간호비용으로 지불된 것으로 나타났다. 우리나라 가정방문간호 유형은 관련법이나 인력, 사업 대상이 다르지만, 서비스 이용자의 건강관리에 효과가 있고, 비용-편익이 상당히 높은 것으로 나타났다. 우리나라 가정방문간호를 발전과 활성화를 위해 세 개 유형의 가정방문간호 서비스가 통합적으로 제공될 수 있는 방안을 모색하고, 근로 조건의 개선, 가정방문간호서비스 제공인력기준이나 방문간호수가 체계의 개선과 같은 법령의 개정 등을 고려할 필요가 있다고 본다.

• 한국보건간호학회지
• /
• 제10권1호
• /
• pp.95-105
• /
• 1996

This study was uncertaken to find an effective management modality for patients with hypertension. Patients 60years or older were selected for this purpose from a general hospital and a welfare center in Pusan and from a public health clinic in Cheju Island. During the month of October in 1984. the management modality for hypertension. the incurred medical expenses. and knowledge about the hypertension were analyzed and compared. The following results were obtained: 1. The a erage total medical expense per year was highest at the general hospital followed by the public health clinic and the welfare center. 2. It was found that the patients chose the public health clinic for its low medical cost. the welfare center for its proximity as well as for its low medical cost. and the general hospital for its quality medical services Also. the study has shown that the prescription of drugs was the major service provided by the public health clinic whereas the blood pressure measurement. the prescription of drugs. and family planning were the primary service offered by the welfare center. Drug prescription and blood pressure measurement were two of the most important services by the general hospital. 3. It was shown that the knowledge of hypertension was highnest at the welfare center whereas the management of hypertension was highest at the public health clinic. Based on above results and considering the chronic nature. it is believed that family awareness of the illness was one of the most important aspects for effective management of the hypertension for the elderly patients. In addition. the health care clinics at every level should come forward to execition of the educational programs and home nursing schomes for the effective management of the hypertension patients.

• The Journal of Korean Physical Therapy
• /
• 제30권5호
• /
• pp.181-186
• /
• 2018

Purpose: This study investigated the effects of home-based exercise intensity on the aerobic capacity and 1 year re-hospitalization rate in patients with chronic heart failure (CHF). Methods: Forty seven patients with CHF (males 33, females 14, age $61.3{\pm}9.8years$) participated in this study. The patients were allocated randomly to 3 groups in accordance with home-based exercise intensity: no home based exercise (NHE, 40%, n=19), moderate intensity home-based exercise (MIHE, 43%, n=20), and high intensity home based exercise (HIHE, 17%, n=8). All patients completed the symptom-limited cardiopulmonary exercise (CPX) test safely at the cardiac rehabilitation hospital. Results: The NHE group significantly showed lower peak $VO_2$ and a higher $VE/VCO_2$ slope than the MIHE (p<0.05) and HIHE (p<0.01) groups. On the other hand, the NHE group did not show significant differences in the other hemodynamic responses, such as heart rate (HR) max, HR reserve, maximal systolic blood pressure (SBP), and SBP reserve. Nine out of 19 NHE patients (47%) were re-hospitalized related to heart disease and two out of 20 MIHE (10%) patients were re-hospitalized, but nobody in the HIHE group were re-hospitalized within 1 year from the CPX test. Conclusion: In patients with CHF, home-based self-exercise is one of the important factors for reducing the re-hospitalization rate. In addition, improved aerobic capacity is strongly associated with a lower re-hospitalization rate. In particular, re-hospitalized CHF patients showed significant differences in respiratory parameters and hemodynamic parameters compared to the non-re-hospitalized patients.

• 가정간호학회지
• /
• 제29권2호
• /
• pp.216-224
• /
• 2022

Purpose: This study aimed to investigate the influence of the perception of the importance of patient safety management and culture on employees' safety performance in small and medium -sized hospitals. Methods: The participants comprised 119 hospital employees, including nurses, doctors, and medical technicians. Data were analyzed through descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis using the SPSS program. Results: The mean safety performance was 4.09±0.34, mean safety compliance was 4.12±0.44, and safety participation was 4.06±0.38. There were significant differences in safety performance by gender and job. Safety performance and its assocation with both perception of importance on patient safety management and, perception of patient safety culture showed a positive correlation. Safety performance was influenced by the perception of patient safety culture. The explanatory power was 15.7%. Conclusion: Based on these results, improving the perception of patient safety culture is necessary to increase safety performance. To this end developing and applying an interprofessional safety performance education program for employees in small and medium-sized hospitals is vital.

• 지역사회간호학회지
• /
• 제1권1호
• /
• pp.503-517
• /
• 1989

This study is to analyze factors affecting the school nurse's activities. The survey was undertaken during Sept. 1-Nov. 30, 1986. The subjects were 137 school nurses from elementary, junior-high, and senior-high schools in Daegu City and Kyungppk Province. The results are as follows: 1. Correlational findings between school nurse's self-confidence and their general characteristics 1) Program Planning & Evaluation: Health Experinece(r=-0.1803, p<0.05) Salary Step(r=-0.1741, p<0.05) 2) Clinic Management: Salary STep(r=-0.2580, p<0.01) 3) Health Education: Salary Step(r=-0.1929, p<0.05) 4) Management of School Environment: Salary Step(r=-0.2501, p<.05) 5) Health Care Services: Health Experience(r=0.1901, p<0.05) Salary Step(r=-0.2424, p<0.05) 2. The degrees of school nurse's self-confidence(high: 4 point, low: 1 point) 1) Clinic Management: 2.92 2) Health Education: 2.86. 3) Program Planning & Evaluation: 2.74 4) Health Care Services: 2.73 5) Management of School Environment: 2.67 6) Operating of School Health Organization: 2.42 3. Significances to self-confidence on school nurse's activities 1) Program Planning as Evaluation: Expending Times for Health Care Services (r=-0.2262, p<0.05) Expending Times for Health Education (r=0.2943, p<0.05) Size of Clinic(r=0.2163, p<0.05) Location of Clinic(t=2.43, gH0.047) Use of Clinic(t=2.06, p<0.007) 2) Clinic Management: Location of Clinic (t=3.36, p<0.010) 3) Health Education: Purchase of Medicine(r=-0.1736, p<0.05) No, of Classes (r=-0.1794, p<0.05) (4) Management of School Environment: School Health Budget(r=0.1731, p<0.05) Home Message(r=0.1805, p<0.05) Location of Clinic(t=4.46, p<0.0001) 5) Operating of School Health Organization: School Health Budget(r=0.1878, p<0.05) Use of Clinic(t:1.90, p<0.018) 6) Health Care Services: School Health Budget(r=1.90, p<0.018) Expending Times for Health Education(r=0.2577, p<0.05) Size of Clinic(r=0.4336, p<0.001) Location of Clinic(t:5.10, p<0.001)

• 한국식품영양학회지
• /
• 제29권5호
• /
• pp.643-654
• /
• 2016

The purpose of this study was to investigate the purchasing behavior and selection attributes for Home Meal Replacement (HMR) and to identify the selection attributes affecting purchasing frequency and purchasing costs of married women living in a city. Among 837 questionnaires distributed to HMR married women consumers, 752 complete questionnaires (89.8%) were analyzed. The younger married women group showed higher frequency of purchasing HMR than the older age group. The 20s and 30s age groups showed higher purchasing costs for HMR than the 40s and older age groups. A higher proportion of employed married women purchased HMR three or more times per week and spent an average of more than 20,000 won per purchase in comparison with unemployed married women. HMR selection attributes were classified into five factors: 'taste and sanitation', 'economic efficiency', 'health and nutrition', 'convenience', and 'reliability and awareness'; mean scores of these factors' importance levels were 4.28, 3.93, 3.59, 3.54, and 3.50 out of 5 points, respectively. The importance level of 'taste and sanitation' factor was significantly greater as married women's age decreased. However, the importance level of 'health and nutrition' factor was significantly greater as married women's age increased. The results of the logistic regression analyses indicate that the 'taste and sanitation' and 'health and nutrition' factors affected frequency of purchasing HMR. The 'reliability and awareness' factor had the most significant impact on cost per purchasing HMR. Therefore, a product differentiation strategy according to married women's age and employment status should be applied. Product qualities and brand value should be improved to enhance competition in the HMR market.

• 가정간호학회지
• /
• 제5권
• /
• pp.20-31
• /
• 1998

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

• 대한전기학회:학술대회논문집
• /
• 대한전기학회 2011년도 제42회 하계학술대회
• /
• pp.2144-2145
• /
• 2011

We carry out a demonstration project to verify performance of a Home- Smart Cabinet Panel(H-SCP) at the child care facility. It is difficult to prevent an electrical disaster using a existing cabinet panel because electrical events are invisible and unforeseeable. So we construct a integrated information system with a Home-Smart Cabinet Panel(H-SCP) for management of low-voltage customers. The integrated information system with the H-SCP maintain the transmitted data from H-SCP, alert a electrical event to a administrator and show a state of customer health in real time respectively. A manager of electrical safety can prevent electrical disaster to maintain electrical facilities after analysis on the integrated information system.

• 보건행정학회지
• /
• 제23권1호
• /
• pp.90-100
• /
• 2013

Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.

• 보건행정학회지
• /
• 제33권1호
• /
• pp.85-106
• /
• 2023

Background: The Korean government has established Health Plan and reinforced tobacco control policies step by step according to Framework Convention on Tobacco Control (FCTC). This study aims to investigate yearly smoking and secondhand smoking (SHS) exposure rates adjusted by demographic and socioeconomic factors. Methods: Multiple logistic regression analysis was conducted about the smoking experience, current smoking, and exposure to SHS at home, at work, and in public places using data from the 6th to 8th Korea National Health and Nutrition Examination Survey (2015-2020). Results: Comparing 2015 with other years, smoking experience rates significantly decreased from 2015 to 2018 in men and significantly increased from 2018 to 2020 in women. Compared to 2015, current smoking rates significantly decreased only in 2020 for men and significantly increased in 2018 and 2019 for women. The rate of exposure to SHS at home significantly decreased until 2018. Rates of exposure to SHS in the workplace and public places were significant all year. Conclusion: There were a slowly decreasing trend in men and an increasing trend in women at current smoking rates. It was found that there were significant decreasing trends at exposure to SHS. There is a need to set policies that reduce current smoking rates and especially to set a customized program to lower women's smoking rates.