• 한국병원경영학회지
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• 제24권1호
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• pp.11-20
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• 2019

The purpose of this study was to identify the factors affecting the use of superior general hospitals on public holidays by using the medical use model (Dutton's medical use model) with the medical panel data. The study found that 34.2% of superior general hospital emergency rooms were used on public holidays and the factors which made statistically significant influences on the use of superior general hospital emergency rooms on public holidays were whether patients were operated or emergency care and inspection etc. Also, there was a difference depending on whether the type of establishment of the medical insititution is national or private. In other words, patients who received emergency care and examinations were found to make more frequent visit to hospital emergency room on pubic holiday, compared to patients who underwent surgery and those who visited emergency rooms in the private superior general hospital did so, compared to those who visited emergency room in the national general hospital(OR, 4.4, 3.386, respectively). Therefore, it is necessary to consider the introduction of integrated care of health and social care medical service that focuses on primary care in Denmark, which focuses on patients, and pre-The Canadian Triage and Acuity Scale(pre-CTAS) in the UK.

• 보건의료산업학회지
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• 제8권3호
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• pp.49-61
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• 2014

Due to the rapid population's aging, the life span's expansion and social & cultural characteristics, the standards of age classes in senescence are changed. Thus, this study aimed to identify the influential factors on health care utilization in the elderly by age class, and targeted 2,937 adults in their ages over 55 years old from the Korea Health Panel's 2009 Yearly Integrated Data. This study investigated the target health care utilization in the elderly in relation with the gender, the education level, the health-care insurance type, the income, the current job state, the chronic disease. In order to analyze the influential factors on health care utilization in the elderly, the multiple linear regression analysis was conducted to the data. As the results from this study, Concerning the influential factors on the health care utilization, the income, the subjective health state, the chronic disease and the regularly meals for the young-old influenced. Concerning the influential factors on the health care utilization, the subjective health state for the old. Concerning the influential factors on the health care utilization, the subjective health state, the income for the older-old influenced. Concerning the influential factors on the health care utilization, the education level, the spouse, the economic activity and the drinking oldest-old influenced. Therefore, it will need to provide systemic health-care & medical services, to develop health-care & medical programs and the health-care & medical policies and to execute them according to the age classes in senescence.

• Perspectives in Nursing Science
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• 제8권2호
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• pp.121-128
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• 2011

Sensitive issues are both common and problematic for health care providers because sensitive issues may interfere with the future provider-client relationship and effective care. Most current training for providers focuses on a particular issue, but this is inadequate because many issues may be sensitive, and which issues will be sensitive is unpredictable. We argue that issues become sensitive when they activate one or more of three common triggers, fear, stigma, and taboo. A cycle of negative internal and interpersonal responses to the sensitive issue often leads to unresolved health issues for clients and stress and feelings of inadequacy for providers. We recommend integrated pre-service and in-service skill building to help individual health care providers respond appropriately to a wide variety of sensitive issues. We also identify specific policies and procedures to strengthen organizational support for caregivers so that providers can address these sensitive issues effectively with their clients.

• 농촌의학ㆍ지역보건
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• 제32권1호
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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.

• 한국보건간호학회지
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• 제20권1호
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• pp.5-15
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• 2006

Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.

• 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.

• 한국가족복지학
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• 제61호
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• pp.59-91
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• 2018

본 연구는 노인환자 치료경험이 있는 노인 의료전문가를 대상으로, 그들이 인식하는 연령주의를 확인하는 동시에, 이러한 장벽을 없애기 위하여 연령통합적인 차원의 노력과 경험들을 어떻게 해왔는지에 초점을 둔다. 연구대상자인 9명의 의료전문가들의 연령주의와 연령통합에 대한 보다 다양한 인식과 경험을 담아내기 위해 CQR 질적연구 방법을 활용해 분석하였다. 의료전문가들은 연령주의(Ageism)에 대한 자기고백의 이중성을 보이고 있었으며, 의료현장에서는비적정진료, 노인 소외와 보호자 의존, 양극화 된 서비스와 빈곤노인에 대한 이중차별의 방식으로 연령주의가 실재(實在)하고 있었다. 이를 완화 혹은 해결하기 위한 방안으로서의 연령통합적 의료서비스 제공에 대해 어려움을 느끼고 있었으나, 소통을 위한 장벽 허물기를 추구하거나, 노인 뿐 아니라 모두에게 보편적(universal)으로 편안한 환경을 제공하거나, 제도와 서비스 기준을 확대 및 다양화하는 방식으로 연령통합적 서비스를 위한 적용노력을 하고 있는 것으로 나타났다. 급격히 증가하는 노인환자들의 건강한 삶과 적정한 의료서비스 보장을 위해첫째, 연령주의를 가속화 시키는 한국 의료체계 내 요소들에 대한 비판적 고찰, 빈곤노인에 대한 관리체계 개선, 의료전문가 제도 내 연령통합관련 커리큘럼 포함, 노인전문 의료서비스와인력양산 그리고 노인과 노인대상 의료영역에 대한 인식개선을 제안하였다.

• Journal of Preventive Medicine and Public Health
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• 제52권3호
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• pp.200-204
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• 2019

On September 12, 2018, President Jae-In Moon announced the Comprehensive Plan for Lifelong Care for People with Developmental Disabilities, with representatives from the associated government branches (Ministry of Health and Welfare, Ministry of Education, and Ministry of Employment and Labor) in attendance. The goals of this plan are to provide health, medical, rehabilitative, special education, and social welfare services according to the life-stages of the affected individuals; to reduce parental pressure; to promote social interventions; and to enhance community-level participation in order to create a 'welfare society in harmony.' However, in order for the plan to succeed, additional efforts must be made in the following areas. First, an epidemiological survey is needed to understand the scale, prevalence, and incidence of developmental disabilities and to establish an evidence base to support policy development. Second, accurate definitions of developmental disabilities must be established in order to avoid policy discrimination based on impairment type and age. Third, personal evaluations to assess disabled individuals' unmet needs and customized service designs to deliver those needs are required. Fourth, the plan must fulfill the goals of accessibility and fairness that the government intends to provide. Fifth, the government should consider an integrated financial support system and to propose a detailed plan for monetary distributions. Finally, an integrated system that links health, medical, employment, educational, and welfare services must be constructed.

• 한국엔터테인먼트산업학회논문지
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• 제15권8호
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• pp.423-432
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• 2021

본 연구에서는 노인의 라이프케어 및 삶의 질향상을 위해 도입되어 시행되고 있는 통합돌봄사업의 미래 가치성 확대와 방향성 제시를 위하여 현황과 문제점들을 알아보고 이를 통해 다음과 같은 연구적 결론을 제시하였다. 첫째, 서비스 수혜 노인의 욕구분석은 조사자 중심이 아닌 환자 중심으로 구성하며, 특히 의료진의 진료방문을 통한 의학적관리 부분이 강화되어야 하며, 성별과 연령, 장애유형과 개인적 욕구취향에 따른 특화된 서비스 항목 부분이 점진적으로 강화되어야 할 것이다. 둘째, 서비스 항목에 대한 만족도 및 중복성 그리고 효과성 등을 분석하여 예산을 절감하며 수요자 중심의 서비스 항목구성과 신규 서비스 필요 항목 적용 등을 고려해 나간다. 셋째, 통합 스케줄관리시스템 도입을 통하여 서비스 제공 직역단체와 수혜자 간의 사전예약 및 방문 스케줄 관리의 전문화가 필요하다. 넷째, 재원 문제해결을 위한 노력으로, 보건의료 재정과 장기요양보험제도 그리고 사회복지재정사업 등과 합리적 재원공유 제도마련이 필요하며, 서비스 관련 산업분야와의 재원의 연계나 순환, 지방 공공의대 출신 인력투입 방안을 고려할 수 있다. 이상의 제안을 통해 통합돌봄사업은 보편적 노인 케어시스템으로의 완성과 미래 가치를 지닐 수 있게 될 것이다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제13권3호
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• pp.25-33
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• 2007

This study is about change a necessary and natural change from institutionalized hospital based health care to a more patient centered, accessible health care. Rapidly change of social and medical facts such as growing aging population, malady, changing of medical policy are made new paradigm. This paradigm is both required to the hospital ; consolidate department and service; architectural change. Benefit to patient and hospital are many, so there are many challenges in Korean general hospital. The purpose of this study is find architectural design guideline to Korean general hospital which is struggling to change from to functional organization to the patient based care center. As a result, the type is divided into three classes, consultation type(C), some of examinations are added on consultation type(EAC), consultation and examination are fully integrated type(CEI). Each type has different organization and the proportion of area, group unit, process of treatment.