• 의학교육논단
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• 제21권2호
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• pp.112-122
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• 2019

The purpose of this study was to identify the current status of the new graduate nurses' education system, to establish guidelines for the education of new graduate nurses, and to provide dates for the improvement of the education system. Eighty-nine hospitals participated in the survey from July to August 2018. The questionnaires consisted of 24 items including general characteristics, new graduate nurses' education system, operation of nursing education teams, and preceptorship programs. The average duration of education/training for new graduate nurses was 57.3 days, and 26.6%-58.5% of general hospitals, hospitals, and long-term care hospitals had less than 30 days of new graduate nurses education/training, which is shorter than the education/training period of tertiary hospitals. There were new nursing education guidelines in 88.8% of all medical institutions and 58.6% of them had nursing education teams. Most of the personnel in charge of nursing education were not dedicated to education. A total of 87.6% of the all participating medical institutions had preceptorship programs, while 23.1%-33.3% of hospitals and long-term care hospitals did not. The breakdown of preceptorship programs showed 68.4% as "preceptor and preceptee are in charge of one team, and preceptor is teaching preceptee," and 19.7% were "preceptor and preceptee are in charge of each team, and preceptor is teaching preceptee at the same time." These results show that standardization and management of new graduate nurses' education programs is necessary. For the standardization and management of new graduate nurses' education programs, joint efforts of nurses' associations and support from the government should be encouraged.

• 보건행정학회지
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• 제19권3호
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• pp.1-26
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• 2009

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

• 한국간호교육학회지
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• 제14권1호
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• pp.127-137
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• 2008

Purpose: This study aimed to explore the level of importance perceived by caregivers of elderly on the education of long term care nursing assistants (LTCNAs) taking care of elders with dementia or stroke. Method: Data was collected from 296 participants (112 families, 98 NAs, and 86 RNs) from October 2006 to February 2007. A structured questionnaire was used for data collection. Result: The item of 'attitude while caring for the aged' was identified as most important. The family group reported that 'position change' and 'understanding of geriatric diseases' were the most important for education, while LTCNAs, highly identified, 'bathing', and 'bed sheet change'. The RNs group regarded 'position change', and 'bathing' as most important. Institutions demanding LTCNAs' activities were special facilities for elderly care and special hospitals for the aged, and the need was also high in families with an elder incapacitated by illness. Conclusion: Nurses need to take an interest in education for enhancing the quality of LTCNAs and thus advance the quality of nursing care as well as the quality of life for the aged.

• 보건행정학회지
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• 제31권4호
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• pp.387-398
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• 2021

Moon Jae-in Care can be seen as a 2.0 version of Roh Moo-Hyun Care. Just as Roh Care failed to achieve its coverage rate goal and 30% share of public beds, Moon Care also failed to achieve its expected goal. The reason is that it followed Roh Care's failed strategy. Failure to control non-covered services has led to a long way to achieve a 70% coverage rate and induced the expansion of voluntary indemnity insurance, resulting in increased public burden. The universal coverage of non-covered services caused an immediate backlash from doctors. And Moon government also failed to control the private insurance market. The expansion of publicly owned beds has not become realized and has not obtained public support. Above all, it failed to overcome the resistance of doctors and failed to obtain consent from budget power groups in the cabinet for public investment. It was also insufficient to win the support of civic groups. Communication with interested groups failed and the role of private health care providers was neglected. The next government should also continue to strengthen health care coverage, but it should prioritize preventing medical poor and create a consensus with both medical providers and consumers for the control of non-covered services. Ahead of the super-aged society, the establishment of linkage between medical services and long-term care and visiting health care or welfare services is an important task. All public and private provisions and resources should be utilized in the view of a comprehensive public health perspective, and public investment should be input in sectors where public medical institutions can perform more effective functions. The next government, which will be launched in 2022, should design a new paradigm for health care in the face of a period of transformation, such as the coming super-aged society in 2026 and the Fourth Industrial Revolution, and recognize that the capabilities of the health care system represent the nation's overall capacity.

• 한국병원경영학회지
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• 제13권4호
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• pp.101-118
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• 2008

Japanese national health expenditure was 8.0% of GDP in 2004, and it was lower than average of OECD countries. But it has increased rapidly in recent years. Japan has relatively many acute care beds and high-price medical equipments, and the average length of stay is long. Japanese government is trying healthcare reform to contain healthcare expenditure, increase the efficiency of management and improve the quality of healthcare. As healthcare policies for hospitals such as DPC (Diagnosis Procedure Combination) for acute care beds, reduction of long-term care beds, and functional differentiation and liaison among healthcare institutions are implemented, the number of hospitals in financial difficulties is increasing. The serious situation urges hospitals to adapt to changes and search new directions of management. They need to establish and implement appropriate positioning strategy, and increase management efficiencies. Korean healthcare system has similarities with Japanese in many aspects. The recent reform and changes in Japanese healthcare system and hospitals give suggestions to Korean hospitals as to how they can prepare for environmental changes and improve management.

• 한국노년학
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• 제31권4호
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• pp.985-998
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• 2011

본 연구는 노인장기요양보험제도 도입 이후 주야간보호사업소 운영현황을 파악하고 가동률 관련 요인을 탐색하고자 하였다. 전국 주야간보호사업소에 2010년 7월 14일에서 7월 28일까지 설문지를 우편 발송하여 설문에 성실히 응답한 277개소의 조사지를 분석하였다(응답률 24.5%). 사업소의 운영주체는 법인이 219개소(79.1%), 개인이 48개소(17.8%), 국공립 등이 10개소(3.6%)이었으며, 평균 가동률은 국공립 등은 79.08%, 법인은 72.49%인 반면, 개인운영 사업소는 57.58%로 낮았다. 사업소 운영주체별로 전체 인력 수에는 차이가 없었으나, 국공립 사업소는 간호사 수가 1.07명인데 비해 개인 사업소는 0.08명으로 유의한 차이가 있었다. 법인 및 국공립사업소가 개인사업소보다 프로그램 실시율이 높았고, 신체활동, 음악활동, 물리치료, 레크레이션, 작업치료 등에서는 통계적으로 유의한 차이가 있었다. 본 연구결과에 기초할 때, 개인운영 사업소와 2008년 이후에 설립된 사업소에 대해 대상자 평가 및 모니터링, 프로그램 실시에 대한 교육훈련 및 서비스 질 관리를 강화할 필요성이 제기된다. 또한, 주야간보호서비스 이용자의 가족에 대한 실효성 있는 지원을 강화하여 주야간보호서비스에 대한 수요를 확대해야 할 것이다.

• 웰빙융합연구
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• 제6권4호
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• pp.63-68
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• 2023

Purpose: This study aims to investigate the national obligation of public health support for residents in medically vulnerable areas in Korea, and to propose a suitable model for public health institutions in this region. Research design, data, and methodology: A survey targeting residents was conducted from August 10 to August 17, 2021, with a sample size of 177 general citizens. The survey utilized a structured questionnaire administered online through Google, employing convenience random sampling. After an editing process to ensure data accuracy, the final dataset of 174 valid samples underwent encoding, coding, and cleaning using the IBM SPSS Statistics 22.0 program for analysis. Results: Health status revealed a moderate level, and 63.8% reported having chronic diseases, particularly prevalent among the elderly. External healthcare institutions were commonly utilized, with proximity and competence of doctors being primary reasons. Respondents expressed a need for improving the public health and medical system, emphasizing the establishment of a County Health Centre and expanding medical departments. Conclusions: In this region, the region's unique challenges, including education, employment, population decline, aging, and transportation, require multidimensional efforts and urgent intervention by public entities. Long-term strategies involve considering the establishment of a health and medical institute, adjusting health centre resources to local realities, and fostering a cooperative system for collaboration among residents and institutions.

• 한국콘텐츠학회논문지
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• 제11권5호
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• pp.270-279
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• 2011

본 연구는 건강보험심사청구자료에 대한 공변량분석과 다중회귀분석을 통해 노인 암환자의 건강보험과 의료급여 이용차이를 분석하고, 의료보장유형이 노인 암환자의 의료이용량에 미치는 영향을 분석함으로써 의료급여 환자의 도덕적 해이가 존재하는지 파악하는 데 목적이 있다. 연구결과, 첫째, 노인 의료급여 암환자가 건강보험 환자에 비해서 장기간 입원으로 총진료비를 많이 사용하고 있었다. 그러나 진료건당 외래진료비와 진료일당 입원진료비는 건강보험 암환자가 많아서 비용이 많이 소요되는 의료서비스를 더 많이 이용하고 있었다. 둘째, 노인 의료급여 암환자일수록 의료기관을 자주 외래방문하고 장기간 입원하여서 총진료비를 많이 사용하고 있었다. 그러나 진료건당 외래진료비와 진료일당 입원진료비는 건강보험 암환자일수록 증가하였다. 노인 의료급여 암환자들의 의료이용량 증가원인이 높은 비급여본인부담을 피해서 본인 부담이 없는 보험급여 의료서비스를 많이 이용 것에 있음을 알 수 있다.

• 한국보건간호학회지
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• 제19권1호
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• pp.108-116
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• 2005

The purpose of this study is to determine the level of recognition of home care services and to provide basic data for implementation of home care services. Data collection was carried out between December 2004 and January 2005 by surveying 88 nurses and 40 physicians working at a general hospital and 28 physicians working at different clinics in the Seoul metropolitan city area. The results of this study were as follows: 1. Home care services were recognized by $94.2\%$ of nurses, $77.5\%$ of physicians and $92.9\%$ of clinic physicians. The main sources of information for most of them were medical and nursing journals. 2. The percentages of staff regarding find home care services as necessary for the institutions were $88.6\%$ of nurses, $74.4\%$ of physicians and $57.1\%$ of clinic physicians. All of them anticipated that home care services would maintain 'continuous care' and 'long-term patient care'. 3. The percentages of staff willing to refer their patients to home care were $95.5\%$ of nurses, $100\%$ of physicians and $87.1\%$of clinic physicians. However, only $7.1\%$ of clinic physicians were willing to refer actively. 4. Most nurses and physicians replied that a majority of test-related services is suitable for home care services. However, among medication-related services, intravenous injections were not suitable for home care services. Among treatment-related services, most nurses and physicians replied that Levin tube feeding, oral and nasal suction, simple dressing, perineal care, and enema were suitable for home care services, but incision and drainage, and tracheostomy tube change were not suitable for home care services. In conclusion, for the implementation of hospital-based home care services, it is necessary to educate nurses and physicians on the present condition and precedent at other hospitals.

• 대한간호학회지
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• 제36권3호
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• pp.475-483
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• 2006

Purpose: The goal of this study was to investigate the factors influencing health promoting behaviors in elderly individuals according to types of residency. Method: This was a descriptive study. The subjects were comprised of 243 elderly aged 65 years or over living in 3 large cities. The instruments used for this study were a health promoting lifestyle, perceived health status, geriatric depression short form scale-Korea, social support scale, and self-efficacy. The data was analyzed using SPSS Win 12.0. Result: Powerful predictors of a health promoting lifestyle were depression, self-efficacy, and perceived health status for the elderly living at home. In the cases of the elderly living in institutions, a powerful predictor of a health promoting lifestyle was identified as social support. Conclusion: For the operation of long-term care insurance, a service for home care programs is needed for the elderly living at home in order to reduce depression and to increase self-efficacy and perceived health status. In addition, social support provided by health-care professionals should be developed to promote a healthy lifestyle for the elderly living in institutional environments.