• 간호행정학회지
• /
• 제14권3호
• /
• pp.229-240
• /
• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• 한국사회복지학
• /
• 제28권
• /
• pp.57-100
• /
• 1996

• 한국산학기술학회논문지
• /
• 제13권2호
• /
• pp.685-693
• /
• 2012

본 연구는 노인요양시설의 노인 연하곤란 조기 발견 및 중재를 목적으로 연하곤란 사정도구를 개발하고 개발된 사정도구를 중심으로 제작된 중재프로그램 적용 효과를 평가하기 위해 실시하였다. 연구대상은 사정도구의 동시타당도 및 신뢰도 검증을 위해 노인요양시설 9곳에 근무하는 간호사 18명을 편의추출하였으며 중재 프로그램 효과 검정을 위해 노인요양시설 4곳의 입소자 50명을 대상자로 선정하여 실시하였다. 연구 결과 연하곤란 사정도구와 중재프로그램 적용 후 실험군의 체중은 증가하였으며(t=4.913, p=.000), 연하 총 시간은 감소하였다(t= -4.557, p=.000). 따라서 본 연구에서 도출된 연하곤란 사정도구와 중재프로그램을 노인요양시설에 적용한다면 노인의 삶의 질 증진과 흡인성 폐렴, 질식과 같은 응급 상황은 감소할 것이다.

• 한국강구조학회 논문집
• /
• 제24권3호
• /
• pp.349-360
• /
• 2012

본 논문은 GFRP 슬래브 교량 상부구조에 대한 장기성능, 내하력, 사용성 및 구조적 안전성의 상세한 평가를 기술하고 있다. 국내 최초로 완전 GFRP 슬래브 교량이 2002년 5월에 가설되었다. GFRP 슬래브 교량은 단순지지로 지간 10.0 m, 폭 8.0 m 인 2차선으로 설계되었다. 본 GFRP 슬래브교량은 콜루게이트(corrugate) 심재를 갖는 샌드위치 구조로서 유리섬유와 비닐 에스테르를 사용하여 수적층으로 제작되었다. GFRP 슬래브 교량의 장기성능 평가는 2002년 수행되었던 동일한 현장재하시험으로 2004, 2011년에 실시되었다. GFRP 슬래브교량은 예상되었던 대로 공용 중에서 구조적 문제점이 없이 성능이 잘 발휘되고 있었음을 평가를 통하여 나타내고 있다. 본 평가 자료는 GFRP 슬래브 교량의 내하력 평가에 대한 기초자료와 완전 GFRP 슬래브교량 상부구조의 장기성능의 일부자료로서 제공될 수 있을 것이다.

• 한국멀티미디어학회논문지
• /
• 제23권9호
• /
• pp.1201-1209
• /
• 2020

Based on the risk factor evaluation for the file format, this paper defines the procedures for presenting the long-term preservation plan for that format and the technical information registry necessary for building the system. This is a procedure to perform a risk assessment for the format, evaluate the risk, and select a long-term preservation strategy based on the information registered in the registry and information on the external signature and internal signature of the electronic record. We also reviewed the criteria for selecting appropriate long-term preservation strategies in the process and provided the criteria for adopting each detailed strategy of migration and emulation, which are long-term preservation strategies. And we implemented this process as a long-term preservation decision support system. This system can be used to provide guidelines for the maintenance, management, service and long-term preservation of information resources of electronic records in public institutions such as National Archives of Korea and Libraries.

• 환경영향평가
• /
• 제6권2호
• /
• pp.81-92
• /
• 1997

This paper presents the results from the comparison analysis and evaluation between the air pollutant dispersion modeling results and the observation data in the area within a 10 km radius from the Boryong thermal power plants. The observation data used in this study were the air pollutant concentrations which had been continuously measured from 8 locations around the Boryong power plants by TMS(tele-monitoring system) for 3 months from September to November, 1996. The short-term and long-term predictions were carried out using ISC3 model and LPDM(Lagrangian Panicle Dispersion Model). The results of ISC3 modeling in a short-term showed highly as 0.7 in a correlation coefficient, but in a long-term showed just 0.54. On the other hand, LPDM showed 0.78 in a correlation coefficient for a long-term, but in a short-term showed highly value than the observation concentrations.

• KIEAE Journal
• /
• 제17권5호
• /
• pp.33-41
• /
• 2017

Purpose: Indoor air quality in residential buildings needs to be evaluated over the long term. In previous research, there has been an attempt to perform the health risk assessment of pollutants by using numerical models as a method of long-term evaluation. However, the numerical model of this precedent study has limitations that do not reflect the actual concentration distribution. Therefore, this study introduces the CRPS index, constructs a numerical model that can reflect the concentration distribution, and then presents a more accurate health risk assessment method using it. At this time, the pollutants are toluene, which is a typical material released from building materials. Method: CRPS index was applied to existing numerical model to reflect concentration distribution. This was used to calculate concentrations at adult breathing area and to use them for exposure assessment in a health risk assessment. After that, we entered adult data and conducted a health risk assessment of toluene. Results: The non-carcinogenic risk of toluene was calculated to be 0.0060. This is 5% smaller than the existing numerical model, meaning that it is more accurate to predict the pollutant risks. This value is also lower than the US EPA reference value of 1. Therefore, under the conditions of this study, long-term exposure of adults to toluene has no impact on health.

• 보건행정학회지
• /
• 제20권4호
• /
• pp.126-138
• /
• 2010

Objectives : The purpose of this study is to evaluate the effects of assistive products usage on activity of daily living for the beneficiary older adults people in Korean long-term care insurance system. The study subjects were divided to assistive products users and non-users among the beneficiary older adults based on Korean long-term care insurance system to compare function improvement of the activity of daily living. Methods : In national wide 12 community elderly care center enrolled the National Health Insurance Corporation, The numbers of 281 beneficiary older adults(long-term care Grade I: 66, Grade II: 58, Grade III: 157) participated in this study. This survey assessment tool for activity of daily living was used the long-term care assessment instrument of the physical functions in the law of Korean long-term care insurance. The function items of Activity of daily living were included in clothing, washing, tooth brushing, bathing, eating, posture converting, stand sitting, move sitting, out of room, using toilet, controlling of stool, controlling of urine, washing hair. According to independence to complete dependence functioning level, remarks pointed 1 to 3 points. The data were analyzed by chi-square, two-way anova using SPSS V. 12.0. Results : The results appeared that the mean score of the functions in activity of daily living of assistive products users was a 27.60, and that of non-users was a 30.66. Assistive products were not effected in Grade I and II recipients, but that effected in Grade III recipients. Conclusion : Preparing for activation of assistive products based Korean long-term care insurance system, the result application as follows is possible. The usage of assistive products could improve the function of daily living activity in older adults. Related to Grade III beneficiary elderly people were improved function in activity of daily living by using assistive products, it is necessary to extend coverage the non-eligible elderly people in Korean long-term care insurance system.

• 보건행정학회지
• /
• 제15권4호
• /
• pp.136-160
• /
• 2005

Before introducing the national long-term care insurance in 2008, the want for long term care service has to be estimated and analysed. This study estimates the demand and analyses what determines the want of long term care service. This study investigated data of 3f6 elderlies, that was collected by age stratified random sampling. The elderies resided in Onyang 4 - dong (urban area) and Dogo-myun (rural area) In the city of Asan. The researchers visited the elderlies and their care giver, and assessed their demand for the long term care service and examined physical, mental, socio-economic status by the assessment tools for Korean Long-Term Care System. $64\%$ of the those who are entitled to be served refuse the long term care service. $26.7\%$ of them wants for home care service and $7.9\%$ want facility care service. It is estimated that the want of home care service are three or four times as much as that of facility care service. The demand for long term care service is 5.155 times higher for those who live in rural area (p=0.000), 3.040 times higher for those who do not have spouse(p=0.057), and 3.356 times higher for the people who is in medicaid than medical insurance(p=0.029). However, income(p=0.782), means(p=0.614), living alone(p=0.223), number of family to live with (p=0.341) and age of the elderly(p=0.420) are not related with the demand of long term care service. The assessment tools for Korean Long-Term Care System for need evaluation of the long term care service can reflect the demand well.(p=0.024) If medical care will cover $80\%$ of total cost, the willingness to pay of the out of pocket money of the people with medical insurance is 67,400 Korean Won(66.77 US$) for the home care service and 182,500 Korean Won(180.78 US$) for the facility care service. There is possibility that long term care demand is still small after Introducing the long term care Insurance due to the care given by family members. When developing service delivery system of long term care insurance, rural area has to be given more consideration than urban area because of the higher demand. The people who do not have spouse or are in medicaid have to be given special consideration as well.

• 대한간호학회지
• /
• 제39권3호
• /
• pp.409-421
• /
• 2009

Purpose: In this research multi-level analysis was done to identify factors related to quality of services. Patient characteristics and organizational factors were considered. Methods: The data were collected from the Health Insurance Review and Assessment Service(HIRA) data base. The sample was selected from 17,234 patients who had been admitted between January 2007 and May 2008 to one of 253 long-term care hospitals located in Seoul, six other metropolitan cities or nine provinces The data were analyzed with SAS 9.1 using multi-level analysis. Results: The results indicated that individual level variables related to quality of service were age, cognitive ability, patient classification, and initial quality scores. The organizational level variables related to quality of service were ownership, number of beds, and turnover rate. The explanatory power of variables related to organizational level variances in quality of service was 23.72%. Conclusion: The results of this study indicate that differences in the quality of services were related to organizational factors. It is necessary to consider not only individual factors but also higher-level organizational factors such as nurse' welfare and facility standards if quality of service in long term care hospitals is to be improved.