As the aging of this society, instead of growing numbers old protective functions of families decreased according to increasing tendency of nuclear families, increasing rates of females' participation of economic activities. Now, the problem of supporting the old is in need of social supporting system the cope with this situation. Thus it needs that welfare service for the elderly who stay at home that have local basis. The results are based on these factors are like this: 1) It is necessarily the instruction of medical welfare service. 2) The overlapped service is avoided and the service of specialized. 3) Most of the welfare service institution is Seoul and local city hall, so it needs the institution is transferred. 4) It needs the increase the number of home helper. 5) When the service is offered, the government must considers finance, elderly health condition and preference. 6) It needs the department for the welfare service for the old who stay at home.
This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.
Purpose: The aim of this study was to estimate optimization model of stay time in EMC. Methods: Data were collected at an EMC in a hospital using medical records from June to August in 2007. The sample size was 8,378. The data were structured by stay time for doctor visit, decision making, and discharge from EMC. Descriptive statistics were used to find out general characteristics of patients. Average mean and quantile regression models were adopted to estimate optimized stay time in EMC. Results: The stay times in EMC were highly skewed and non-normal distributions. Therefore, average mean as an indicator of optimal stay time was not appropriate. The total stay time using conditional quantile regression model was estimated about 110 min, that was about 166 min shorter than estimated time using average mean. Conclusion: According to these results, we recommend to use a conditional quantile regression model to estimate optimal stay time in EMC. We suggest that this results will be used to develop a guideline to manage stay time more effectively in EMC.
Purpose: This study aimed to determine the levels of burnout, self-efficacy, intention to stay, and organizational citizenship behavior (OCB) among nurses in small- and medium-sized hospitals, and factors related to nurses' OCB. Methods: A targeted sampling method was adopted, whereby 185 clinical nurses employed at 1 of 4 hospitals were enrolled in the study. OCB was measured with a tool developed by Podsaoff et al. Associated factors, including nurses' general characteristics, burnout, self-efficacy, and intention to stay, were measured using a structured survey. Data were analyzed by frequencies, t-test, ANOVA, Duncan's multiple test, Pearson Correlation Coefficient and multiple stepwise regression. Results: Levels of OCB in nurses was on average 3.52 on a scale of 1 to 5, exhibiting a positive correlation with self-efficacy and intention to stay, and a negative correlation with burnout. The final related factors were self-efficacy, burnout and intention to stay with a predictive and explanatory power of 52% for OCB. Conclusion: To increase the level of OCB of nurses, an environment in which such behavior is encouraged needs to be established by introducing measures related to administrative support and task efficiency that reduces mental burnout, while increasing self-efficacy and intention to stay.
Purpose: The purposes of this study were to examine the relationships among the sense of control, social support, depression and nursing home adjustment, and to identify the influencing factors of nursing home adjustment in nursing home residents. Methods: The study design was a cross-sectional descriptive study. Data were collected from May to June of 2010 using structured questionnaires from 212 elderly residents without dementia from 15 nursing homes. Results: The levels of nursing home adjustment depended on the self-rated health, the voluntary institutionalization, and the length of stay. The nursing home adjustment was significantly correlated with a sense of control, social support and depression. The five most influential factors affecting adjustment were self-rated health, placement decision maker, the length of stay, a sense of control and depression, which explained about 51.5% of the variances. Conclusion: The findings reflect the importance of voluntary institutionalization, a sense of control, avoiding depressive mood and social support which facilitate residents' adjustment. These results can provide guidance for nursing interventions to facilitate nursing home adjustment.
As the aging of this society, instead of growing numbers old protective functions of families decreased according to increasing tendency of nuclear families, increasing rates of females' participation of economic activities. Now, the problem of supporting the old is in need of social supporting system the cope with this are based on these factors are like this: 1) It is necessarily the instruction of medical welfare service. 2) The overlapped service is avoided and the service of specialized. 3) Most of the welfare service institution is Seoul and local city hall, so it needs the institution is transferred. 4) It needs the increase the number of home helper. 5) When the service is offered, the government must considers finance, elderly health condition and preference. 6) It needs the department for the welfare service for the old who stay at home.
This study was to compare the functional status. complication and readmission rates. and client satisfaction with nursing care of home-based care and hospital-based care for clients with Coronary Artery Bypass Graft. Raw data were collected by interviewing and reviewing charts of 41 clients with Coronary Artery Bypass Graft between June 2001 and July 2002 at an university hospital located in Seoul. Korea. Out of 41 clients. 15 were in home care group and 26 were in hospitalization group. The baseline characteristics of the groups were almost identical. Mean age was 61.7 and 75.6% of clients being male. For home care group. the data collection was made at discharge and at termination of home care. and for hospitalization group. at discharge and at the first visit of outpatient department. Complication and readmission rates were investigated at one month after operation. Collected data were then analysed by conducting Chi-square test. Wilcoxon rank sum test. and Wilcoxon signed ranks test with SPSS program. The level of significance was .05. The results of the study are summarized as follows: 1. Postoperative length of stay of the home care group was shorter than that of hospitalization group by 1. 14 days(8.45 days vs. 9.59 days). On average. 1.8 home visits per client were observed. 2. The functional status (Barthel Index) at the termination of home care was significantly increased from that at discharge. For hospitalization group. a significant increase was observed between the functional status at the discharge and that at the first visit of outpatient department. The differencies in incremental of the scores. between the groups. were however not significant. 3. Complication and readmission rates; no statistically significant difference between the groups was observed. 4. The client satisfaction with nursing care (CSS) at termination of home care was significantly higher than that at hospital discharge. In conclusion. the outcomes of the analysis suggest that the home care benefits clients with Coronary Artery Bypass Graft. Client satisfaction with nursing care rises at termination of home care as compare to that measured at hospital discharge. Meanwhile. there was no significant differences in functional status. and complication and readmission rates. Further. home care reduced the length of stay in hospital.
본 논문의 연구 목적은 공유숙박 비즈니스 바탕으로 숙박 플랫폼이 세입자의 온라인 리뷰 의향에 미치는 영향을 연구하는 것이다. 기존 숙박예약 모델보다 공유숙박 중 숙박 플랫품, 집주인, 세입자 간을 공유하는 독립성이 더 명확하다. 공유숙박 플랫폼은 집주인과 세입자간의 오프라인 숙박서비스를 완료하고 거래를 실현할 수 있도록 다양한 지원 서비스를 제공하는 것은 물론, 공유숙박 플랫폼은 세입자가 집주인에게 객관적이고 적극적으로 평가하도록 장려하는 특정 조치를 파악해야 한다. 공유숙박에 대한 신용 생태를 더 잘 확립할 수 있도록 필요하다. 본 논문에서는 공유숙박 플랫폼을 사용해본적 있는 소비자들을 대상으로, 2주간의 설문 조사를 하고 SPSS24.0 프로그램을 사용하여 데이터가 분석되었다. 이 논문의 연구결과는: (1) 플랫폼 리뷰 기능의 사용 용이성, 세입자의 만족도 및 플랫폼 리뷰 인센티브가 세입자의 온라인 리뷰 의향에 긍정적인 영향을 미친다. (2) 플랫폼의 신용 메커니즘은 세입자의 만족도가 온라인 리뷰 의향에 영향을 미치는 과정에서 긍정적인 영향을 미친다.
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.
Facing the aging society in Korea, the supply of elderly care services has to be increased. Among these services short-stay care service is one of the alternative service connecting home and communities and this service is at the beginning stage in Korea. This paper aims to identify the current status and characteristics of short-stay care facilities in Korea. On the bases of survey and analysis the basic data for architectural planning and design of short-stay care facilities for elderly have been proposed.
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