• Title/Summary/Keyword: home visiting

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Long-term oxygen therapy in patients with chronic respiratory failure in one university hospital (호흡부전환자의 재택산소치료 실태: 한 대학병원에서의 관찰)

  • Huh, Jin Won;Lee, Jung Yeon;Hong, Sang-Bum;Oh, Yeon Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.2
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    • pp.160-166
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    • 2005
  • Background : Although home oxygen therapy in hypoxemic patients with chronic lung disease has been increasing over the decade in Korea, the present state has not been known well. This study was done to know the situation of home oxygen therapy in a Korean university hospital. Methods : Between January 1, 2000 and August 31, 2003, 86 patients prescribed home oxygen therapy by the pulmonary physicians of Asan Medical Center were investigated using their medical record and questionnaire. Results : Patients (52 men, mean age of 61 years) with home oxygen therapy were increasing by every year. Underlying diseases were COPD (n=29), tuberculous destroyed lung (n=18), bronchiectasis (n=15), ILD (n=12), and others. Baseline $FEV_1/FVC$, FVC, and $FEV_1$ of patients were $58.4{\pm}25.2%$, $54.5{\pm}17.1%$ of predicted, and $41.7{\pm}20.6%$ of pred. Mean oxygen flow was 1.5 L/min and mean duration per day was 14.5 hours. During therapy, mean $PaO_2$ values have increased from 51.2 to 77.7 mm Hg and $PaCO_2$ values have increased from 47.5 to 49.6 mm Hg. Only 16.5% of the subjects were monitored by visiting nurses or pulse oximeter. Three year survival rate was 56.6% and hypercapnic patients showed better prognosis. Conclusion : The patients with home oxygen therapy were increasing yearly and a part of them were monitored. The hypercapnea respiratory failure patients would have better prognosis.

A Preliminary Study for Expending of Hospital-Based Horne Health Care Coverage - Focused on Accident Inpatients Who has the Workers Compensation Insurance - (병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구)

  • Lee, Sook-Ja;Lee, Jin-Kyung;Ryu, Ho-Sihn
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.6
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    • pp.5-18
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    • 1999
  • 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.

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A Case Study on the Green Campus Operating System - Focused on the Green Campus Support Institutions of the United States and Harvard University - (그린캠퍼스 운영체계에 대한 사례연구 - 미국 그린캠퍼스 지원기관 및 하버드대학을 중심으로 -)

  • Kim, Dong-Hyun;Lee, Hyun;Jeon, Kang-Eun;Kim, Sei-Yong
    • Journal of the Korean Institute of Educational Facilities
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    • v.20 no.4
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    • pp.11-22
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    • 2013
  • The concept of Green campus has recently become an issue with the fact that universities are classified as energy gluttons. This study clearly defines the meaning of domestic green campus, and explores the operating system of green campus and related associations. Then, it draws implications from the case of Harvard University. For the research, reports and research papers of the University are examined thoroughly, and detailed information were confirmed through visiting to the official home page and emails with authorities. The green campus support institutions of the United States are making efforts to integrate overlapping functions and create a synergy effect through internal interchange and information exchange, and substantive collaboration. Also, it is drawing active participation from students and faculties of American universities by publicizing and raising various methods of funding to manage them. The primary factors of Harvard University's success are: voluntary participation from all members, the coordinated operation of the administrative division to be the center of the green campus initiative and the cooperation of each department. Other critical factors of Harvard's success are their fundraising capability, and specialized management institution. The study has significance in that it draws applicable implications on domestic Green campus through in-depth analysis, which surpasses introduction of preceding studies.

A Study on the Improvement in Spatial Planning of Orphanage Facilities (아동양육시설의 공간계획 개선에 관한 연구)

  • Yoo, Myoung-Hee
    • Korean Institute of Interior Design Journal
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    • v.21 no.1
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    • pp.228-239
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    • 2012
  • This study aims to propose the improvement direction of spatial organization of orphanage facilities by reflecting the international trend of child welfare facilities including 'enhancement of habitability', 'opening to the local community' and 'multi-functionality' on the basis of ideas of 'right of housing' and 'normalization'. Orphanage facilities are evolving from 'facilities' to accommodate unfortunate children to the concept of the 'community-care', and the residential space is also rapidly shifting to 'cottage' type resembling a residential type of ordinary family so as to enhance the self-esteem and relationship. To suggest the future-oriented changeability of current orphanage facilities, the present study conducted a nationwide survey of child welfare facilities and four Visiting researches of cottage type orphanage with different locations to investigate the appropriateness of housing type, organization of common use space, mode of management and facilities criteria. The results of this study are following: 1) For enhancement of habitability it is suggested that cottage type with various plans in the form of ordinary housing is appropriate, that the number of children per cottage is six or so, and that the number of less than two or three children per room is recommended. At the same time the adjustment of facilities criteria, simplified or complex, is suggested to support a similar residence pattern to ordinary home. 2) Specialized programs must be introduced to establish a base of welfare-network for community children according to features of location and a complex management must be sought in the connection with neighboring public facilities. 3) To secure the residential environment and quality of life for children, the concept of a simple playground space by the current facilities criteria must be broken away to reinforce the network of various outdoor spaces closely connected with living space.

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Need of Health Center-based Integrated Healthcare Services for the Elderly in Rural Area (농촌지역 보건소 중심의 노인 통합보건의료서비스 필요도)

  • Won, Eun-Sook;Chang, Sei-Jin;Park, Jong-Ku;Hyun, Sook-Jung;Kim, Chun-Bae
    • Journal of agricultural medicine and community health
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    • v.32 no.1
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    • pp.27-39
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    • 2007
  • Objectives: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. Methods: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. Results: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. Conclusions: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.

Analysis of Sub-Behaviors according to Elderly Resident's Level of Independence for Performing the Behaviors at Home (주거공간에서의 고령자 행위별 자립도에 따른 세부행위 분석)

  • Kwon, Oh-Jung;Kim, Dongsook;Lee, Yongmin
    • Journal of the Korean housing association
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    • v.27 no.6
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    • pp.125-136
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    • 2016
  • This study specifies daily behaviors that elderly residents perform in their living space and verifies the behaviors that they have difficulties in performing. The study categorized elderly people according to the level of difficulties they have when performing household activities (independence of behavior performance) and verified characteristics of the sub-behaviors and the level of difficulties of performing them in each type. For this purpose, the study conducted observation investigation on the behavior of elderly people by directly visiting houses of 52 elderly people over the age of 65. The characteristics of sub-behavior were also examined through photograph shooting and in-depth interview. In this study, behaviors of elderly people inside living space were categorized into the following nine behaviors. The study investigated the difficulties of performing these sub-behaviors according to the elderly people's level of independence by each behavior. Analyzing the difficulties of sub-behaviors according to the independence level, elderly people felt more structural problems and inconvenience in using facilities when they have lower independence level. Moving from independence to dependence, their performance of behaviors gradually became difficult, making them inevitable to use tools. At last, they came to need caregiver's help. For continuous sustenance of elderly people's independent living inside house, policy measures are required that can address the difficulties of sub-behaviors that are observed in a series of process of one's becoming dependent from independent in this study.

Development of Neuromuscular Stimulus System using Wearable Ultra-miniature Lighting Modules and its Verification of Clinical Effectiveness (의복형 초소형 발광모듈을 이용한 신경근육 자극 시스템 개발 및 임상적 효과 검증)

  • Park, Se-Hyeong;Lee, Jong-Shill;Kim, In-Young;Kim, Sun-I.
    • Journal of Biomedical Engineering Research
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    • v.30 no.1
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    • pp.23-33
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    • 2009
  • It can be used easily to reduce rehabilitation and treatment time if diagnostic and therapeutic devices are attached to cloth or body. Therefore we developed neuromuscular wearable ultra-miniature lighting modules which can improve the neuromuscular function and verified its clinical effectiveness. The system is based on the ultra-miniature lighting treatment module and there are two types of systems. One of them is designed as an attached type and the other type is combined with clothing. The wearable ultra-miniature lighting module is composed of controller (battery, MCU, bidirectional transmitter and receiver), cable, treatment medium generating device and other peripheral devices. To verify the clinical effectiveness of this device, we observed the difference of the strength of a muscle before and after 650nm and 25mW laser irradiation on the reflex point for 1 to 4 seconds. Among 48 patients having the degenerative osteoarthritis, the muscle strength before and after irradiation of laser was $21.8{\pm}7.99$ and $27.3{\pm}8.43$. According to the result, the muscle strength after treatment was significantly increased (p<0.01). To whom having difficulty in visiting to OPD(Out-Patient Department), doctors medically examine the patients and find the therapeutic point, attachment of this wearable ultra-miniature lighting module can function as self treatment (treating instrument) and treatment assist at home. If doctor can remotely control the patient and take part in treatment, the therapeutic device could contribute to prevention and care device.

Validation of Instruments to Classify the Frailty of the Elderly in Community (지역사회 거주 노인의 허약선별도구 타당도 평가)

  • Lee, In-Sook;Park, Young-Im;Park, Eun-Ok;Lee, Soon-Hee;Jeong, Ihn-Sook
    • Research in Community and Public Health Nursing
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    • v.22 no.3
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    • pp.302-314
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    • 2011
  • Purpose: This study aimed to validate instruments to classify the frailty of Korean elderly people in community. Methods: For this study, 632 elders were selected from community-based elderly houses and home visiting registries, and data on frailty were collected using three instruments during November, 2008. The Korean Frail Scale (KFS) was composed of 10 domains with the maximum score of 20. The Edmonton Frail Scale (EFS) had 10 domains with the maximum score of 17. The 25_Japan Frail Scale (25_JFS) was composed of 6 domains with the maximum score of 25. Internal consistency was measured with Cronbach's ${\alpha}$. Sensitivity, specificity and area under the curve (AUC) of ROC were measured to see validity with long.term care insurance grade as a gold standard. Results: The Cronbach's ${\alpha}$ was .72 for KFS, .55 for EFS, and .80 for 25_JFS. Sensitivity, specificity, and AUC were 70.0%, 83.2%, and .83, respectively, at cutting point 10.5 for the KFS, 50.0%, 80.9%, and .66, respectively, at 8.5 for EFS, and 80.0%, 85.9%, and .86, respectively, at 12.5 for 25_JFS. Conclusion: KFS and three JFS showed favorable internal consistency and predictive validity. Further longitudinal studies are recommended to confirm predictive validity.

Needs for the Housing Consultation and Information about Housing in Seoul Area (서울시 거주자의 주택상담과 자료 요구도에 관한 연구)

  • 강순주
    • Journal of Families and Better Life
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    • v.16 no.2
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    • pp.71-82
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    • 1998
  • This study aimed to aimed to obtain some basis data for the housing consultation and information about housing through survey of needs for the housing consultation. Respondents were housewives from 395 households living in Seoul area. Questionnaire was used for survey and the collected data were classified by two items such as types of residence and age of housewives. The survey was performed during two weeks in September 1997 and analyzed by frequency mean and percentage using SAS program The finding are as follows; (1) According to the actual conditions of housing consultation the main source of information related to housing was a newspaper Those who had experience detached house had much more opportunities than those of multi-family house. The most frequent agency for housing consultation was a realty dealer showing 65.8%. However the percentage of visiting permanent housing exhibition centers was high among the people aged 20 to 30, noted 20.4%. (2) Level of understanding housing consultation showed 3.45 points among 5. This result indicated that the service system of housing consultation were required. Architects and interior designers were most preferred as specialists whom the respondents wanted to consult with . As to the contents of consultation the most required item was changing of interior space(22.6%). In case the housing information leaflet is sold the respondents were willing to pay 523 won for each of it. (3) Among leaflets related to various information leaflets about housing purchase were most preferred(21.0%) According to the result of the survey the need for the information about housing purchase indicated higher preference than about housing management. The fact could be thought that consumers' consciousness of housing should be changed. Therefore it is desirable to lead consumers to lengthen the expected life span of their house and value happiness of the house by providing them with consulting systems about housing management throug housing consultation materials and development of its programs.

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Study on The Customer Service of Hospitals and Clinics According to Franchised Form or Not

  • Lee, Kyung-Soo;Nam, Seok-Woo;Choi, Young-Soo
    • Journal of Korean Clinical Health Science
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    • v.2 no.2
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    • pp.148-157
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    • 2014
  • Purpose. This study compares and analyzes customer service on customer satisfaction and customer royalty on customer satisfaction targeting the customers visiting a hospital or a clinic which is franchised or not. And it aims at helping business rationalization for a medical institution. Methods. This paper conducts a survey and selects a sample of 670 customers except the missing value targeting the customers of 4 primary health care institutions and 4 bigger health care institutions in Seoul and Gyeonggi province. It conducts frequency analysis for the purpose of investigating the respondents' generic characteristic and factor of their medical institution selection, and factor analysis, reliability analysis and regression analysis for the hypothesis testing. Results. The first hypothesis testing result is significant in level of significance of 0.01. The second one is the same as the first one, but the dummy variable shows a negative regression coefficient(-0.479). The third one is significant in level of significance of 0.01, but the forth one is not significant. And the respondents prioritize website(Home page) and convenience in use of a hospital procedure for selecting a hospital or a clinic. Conclusions. The additional analysis finds that the franchised group has more satisfaction than none franchised group. But in case of their royalty, the average of franchised and none franchised groups are not significantly different. Therefore, the results of this paper reveal to support the results of the advanced researches.