• 보건행정학회지
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• 제3권1호
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• 문화기술의 융합
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• 제10권3호
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• pp.675-681
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• 2024

본 연구는 노인장기요양 시설의 요양보호사를 대상으로 요양보호사의 직무특성과 조직의 맥락적 성과에 관한 매개효과를 실증 검증한 연구로서 직무태도, 조직풍토의 이중매개효과를 실증분석 하는 것을 목적으로 한다. 본 연구를 위하여 노인장기요양 시설에서 근무하고 있는 요양보호사 274명을 대상으로 하였다. 수집한 자료 분석은 SPSS Process macro를 사용하였다. 다음과 같은 연구결과가 나왔다. 먼저, 요양보호사의 직무특성, 직무태도, 조직풍토, 맥락적 성과는 유의미한 정적 상관관계를 가지고 있었다. 둘째, 요양보호사의 직무특성과 맥락적 성과 사이에 직무태도, 조직풍토는 이중매개효과가 있었다. 셋째, 요양보호사의 직무특성과 맥락적성과 사이에 직무태도와 조직풍토는 유의한 매개효과 경로가 있는 것으로 확인되었다. 연구를 바탕으로 요양보호사의 직무성과를 향상할 수 있는 심리적인 자발적인 직무역량 방안 마련과 후속 연구를 제안하였다.

• 한국노년학
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• 제41권2호
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• pp.217-240
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• 2021

본 연구는 요양보호사의 고용특성과 시설장에 대한 변혁적 리더십 인식이 서비스 질에 미치는 영향을 위계적 선형모형(Hierarchical linear model)을 통해 검증하고자 하였다. 이를 위해 서울시에 위치한 45개의 노인 장기요양시설에 거주하는 노인 240명과 장기요양서비스를 제공하는 요양보호사 200명을 대상으로 설문자료를 수집하고, SPSS 26.0과 HLM 8.0을 사용하여 자료를 분석하였다. 분석결과, 시설장에 대한 변혁적 리더십 인식은 서비스 질에 정(+)적 영향을 미치는 것으로 나타났지만 요양보호사의 고용특성 중 고용형태와 근무시간은 부(-)적 영향을 미치는 것으로 나타났다. 즉, 요양보호사가 정규직인 경우, 근무시간이 적을수록, 요양보호사들이 인식하는 시설장의 변혁적 리더십이 높을수록 서비스 질이 높아지는 것으로 나타났다. 반면, 임금, 총경력, 근속기간은 서비스 질에 유의한 영향을 미치지 않는 것으로 나타났다. 이러한 연구결과를 바탕으로 다음과 같은 정책적 제언을 제시하였다. 첫 번째, 요양보호사의 시급제 비정규직의 지위를 월급제 정규직화하기 위한 인센티브제 활용 및 급여체계 개편과 관련예산 확보, 나아가 전문성 강화를 바탕으로 근본적인 직업적 가치 인정을 통한 고용안정 강화 노력이 필요할 것이다. 장기요양의 공공성 강화 및 거점 공공장기요양시설 설립을 통한 지향 모델 제시 또한 방안으로 제시될 수 있을 것이다. 두 번째, 근로기준법상 요양보호사의 근로시간, 휴게시간, 연차 사용 등을 준수하는 등 적정 근로시간 유지 및 야간 근무자에 대한 수당 강화와 근무시간 감소 노력이 필요하다. 세 번째, 시설장의 변혁적 리더십 고취를 위한 교육과 개입이 필요하며, 시설장의 자격 기준을 강화해야 할 것이다. 본 연구에서 제안한 요양보호사의 고용안정 및 근무시간에 대한 정책적 지원과 시설장의 변혁적 리더십 증진을 위한 정책적 지원은 정책 입안자들뿐만 아니라 현장의 종사자들이 서비스 질 제고를 위한 방안으로 활용할 수 있다는 측면에서 중요한 의미가 있다고 할 수 있다.

• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.97-119
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• 1991

본 연구는 농촌지역의 보건의료수준이 의료자원의 양적, 질적 격차와 의료이용과 의료접근도 및 건강수준의 면 등에서 도시지역보다 낙후되어 있다는 사실을 각종 통계지표를 이용하여 논증하였다. 다음으로 이러한 격차를 빚은 농촌보건사업의 문제점을 파악하여 이에 대한 대처방안을 농촌보건사업의 조직, 인력, 시설 및 장비, 재원 및 그리고 관리라는 5가지 부문으로 나누어서 모색해 보았는데 구체적으로는 첫째, 농촌보건 인력의 자질향상과 적정배치방안의 수립, 둘째, 농촌보건인력의 생산성 증대, 셋째, 보건소 및 지소의 운영개선, 넷째, 취약지 민간병원의 운영 개선, 다섯째, 사회, 경제여건의 변화에 따른 새로운 보건사업의 개발, 여섯째, 통합적인 보건의료인력관리 전담기관의 설립 등의 정책대안을 제시하고 있다.

• 대한간호학회지
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• 제38권1호
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• pp.29-38
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• 2008

Purpose: This study investigated various factors relatied to wandering behavior of Korean elders with dementia (KED). Methods: A sample of 160 ambulatory residents with dementia from 14 long term care facilities was used to examine demographic, individual, cognitive, physical health, and environmental characteristics by comparing wanderers (N=108) to nonwanders (N=52). Subjects were evaluated by Korean versions of the Mini-mental State Exam (K-MMSE), the Physical and Instrumental Activities of Daily Living (K-PIADL), and the Revised Algase Wandering Scale Nursing Home version (KRAWS-NH) along its six dimensions. Demographic and environmental data were also obtained. Independent sample t-tests, Chi-square test, Fisher's Exact tests, and ANCOVAs were used to examine differences between wanderers and nonwanders. Results: Wanderers were significantly (p<.05) older and had more limitations in K-PADL and K-IADL. The degree of overall wandering and certain features of wandering were significantly different (p<.05) by total number of residents in the facility, type of bedroom (i.e., "Ondol"), and color of bedroom and living-room walls (i.e., sky blue). Conclusions: Findings of this study may be useful in understanding wandering behavior of KEDs and thus developing more culturally specific management strategies.

• Journal of Korean Biological Nursing Science
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• 제20권3호
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• pp.150-158
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• 2018

Purpose: The purpose of this study was to investigate the expected family involvement of family members of elderly residents in nursing homes. Methods: This study utilized a descriptive design with a survey research method. Data were collected using the Expect Family Involvement Questionnaire Scale, which was completed by 112 family caregivers of older adults in nursing homes in Seoul and Gyeong-gi Province. The collected data were analyzed using descriptive statistics. Results: Responses to the questionnaire indicated the highest value was recorded for the item, 'use of a room for family privacy' with $2.41{\pm}0.43$ points, followed by the item, 'staff calling family for advice with resident problems' with $2.38{\pm}0.38$ points and 'education about nursing home programs' with $2.32{\pm}0.42$ points. Conclusion: In order to promote family involvement in long-term care facilities, various approaches, interventions, and government supports with the respective of the family are required. The nursing home placement process should include understanding discuss on the importance of the role of family, and should help promote positive relationships between the elderly residents and their families. Staffs and administrators of nursing home are to consider the family as a partner rather than visitor.

• 지역사회간호학회지
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• 제13권4호
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• pp.668-678
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• 2002

Purpose: The number of nursing home residents has been increasing in Korea. Nurses need to know the lived experience of relocation of the elderly to long-term care facilities. However, studies on this issue has not yet been conducted in Korea. Therefore, this study was carried out to understand the experience of institutionalization of the elderly using a phenomenological approach. Method: There were 11 participants who consisted of 5 men and 6 women living in 3 different nursing homes. The data was collected through in-depth interviews and participant observation from June 1999 to October 2001, and analyzed by Colaizzi's phenomenological method. Result: A total of 275 meaningful statements related to the experience of institutionalization by the elderly were obtained. Of the 275 statements, 175 were found as the statements with more general forms. 28 themes were grouped into 8 theme clusters. These theme clusters included' resentment at their sons', irresistible admission', 'humiliation on institutionalization', 'being unbearable to shock', 'grief to unfamiliarity', 'being in agony of outwards', 'regret for self-life' and 'comfort for new residence'. Conclusion: Based on these results. we can understand the lived experience of institutionalization of the Korean elderly. We need to develop a nursing program to help the elderly cope with this crisis, and studies about the familys experience on their parents admission to institutionalized facility warrant further exploration.

• 한국주거학회논문집
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• 제21권1호
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• pp.171-180
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• 2010

Amongst society's transitional presuppositions towards the future, population aging is the most critical issue in Korea. Immediate attention to devise a countermove is required. One of the major trends appeared in retirement communities of advanced countries is social integration which has been considered as a promising future direction of elderly housing development. This study aims to find out social integration characteristics and to categorize local engagement types of recent retirement communities through the characteristics of sharing common facilities and programs. Data were collected through mainly web site and literature reviews. Contentent analysis technique was used. Ten CCRC cases were selected through web search using the major key words such as 'intergenerational'. As a result, community engagement types were classified into six categories by the degree of sharing both physical and program resources between the retirement community and local area. This type can be utilized to develop alternative housing and retirement community for the older adults as a new model which activates the resident and vitalizes the retirement community through local engagement by physical and social resources.

• Smart Structures and Systems
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• 제6권3호
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• pp.309-333
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• 2010

Civil infrastructure, in both its construction and maintenance, represents the largest societal investment in this country, outside of the health care industry. Despite being the lifeline of US commerce, civil infrastructure has scarcely benefited from the latest sensor technological advances. Our future should focus on harnessing these technologies to enhance the robustness, longevity and economic viability of this vast, societal investment, in light of inherent uncertainties and their exposure to service and even extreme loadings. One of the principal means of insuring the robustness and longevity of infrastructure is to strategically deploy smart sensors in them. Therefore, the objective is to develop novel, durable, smart sensors that are especially applicable to major infrastructure and the facilities to validate their reliability and long-term functionality. In some cases, this implies the development of new sensing elements themselves, while in other cases involves innovative packaging and use of existing sensor technologies. In either case, a parallel focus will be the integration and networking of these smart sensing elements for reliable data acquisition, transmission, and fusion, within a decision-making framework targeting efficient management and maintenance of infrastructure systems. In this paper, prudent and viable sensor and health monitoring technologies have been developed and used in several large structural systems. Discussion will also include several practical bridge health monitoring applications including their design, construction, and operation of the systems.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 추계학술대회
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• pp.523-525
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• 2022

현재 경증치매노인은 노인장기요양보험법에 의해 치매안심센터나 지역의 주간보호센터에서 인지프로그램을 제공받을 수 있지만, 인지프로그램 운영에 대한 명확한 정의나 지침은 미비한 상황이다. 최근 VR에 대한 관심도가 높아지면서 다양한 노인복지시설에서 VR을 활용한 프로그램을 시도하고 있지만 신기술에 대한 친밀도나 활용도에 대한 분석이 많지 않은 편이다. 따라서 본 논문에서는 노인주간보호센터에서 경증치매노인을 대상으로 VR 활용도를 조사하고 분석하였다. 활용도는 친밀도와 활용가능성으로 나누어 조사하였고, 친밀도화 활용도 모두 높은 편으로 분석되어, 향후 경증치매노인을 대상으로 VR 인지프로그램 개발이 필요함을 알 수 있었다.