• 제목/요약/키워드: managed care

검색결과 303건 처리시간 0.023초

한방병원 중증치료실 입원 환자의 임상적 분석 - 주 질환 및 합병증 위주로 - (Clinical Study about Patients in Intensive Care Unit at an Oriental Medical Hospital - Focused on Main Disease and Complications -)

  • 노현인;이지숙;윤다래;이서라;류재환
    • 대한한방내과학회지
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    • 제33권2호
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    • pp.172-179
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    • 2012
  • Objectives : This study was designed to quantify the characteristics, main diagnosis and complications in the intensive care unit (ICU) at an Oriental Medical Hospital. Methods : The medical records of 44 patients admitted to the ICU at Kyunghee Oriental Medical Hospital between January 1, 2011 and December 31, 2011 were reviewed. Basic characteristics of patients, admission channel, main diagnosis, east-western medical therapy, mortality, and complications were investigated retrospectively based on medical notes. Results : 1. The total number of patients was 44. Males were 63.6%, females 36.3%. Average admission days was 15.9. 2. The most frequent age group is eighties, 38.6%. 3. The most frequent disease is cerebrovascular disease, 61.3%. 4. The medical therapy done after admission to ICU was intubation. Central vein insertion was performed next, followed by Foley's catheter insertion, ventilator, tracheostomy, nasogastric intubation, and thoracentesis in order. The proportion of Oriental medical treatment provided to the patients of ICU was as follows: herbal medication only 6.8%; herbal medication plus acupuncture 31.8%; herbal medication, acupuncture electro-acupuncture, plus subcutaneous acupuncture 2.3%; and none 27.3%. 5. The number of cases of complications occurred since ICU admission was 18. The most frequently observed complication was infection, including 6 cases of pneumonia and 4 cases of urinary tract infection. Conclusions : We suggest that ICUs of Oriental medical hospitals need to be managed effectively to treat diseases including cerebrovascular disease and prevent complications.

소규모 사업장 보건관리 모델개발에 관한 연구 (Occupational Health Care Management Model in Small Scale Enterprises)

  • 윤손녕;정혜선
    • 지역사회간호학회지
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    • 제12권3호
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    • pp.647-660
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    • 2001
  • Forming health care management model in small-scale enterprises was the purpose of this study. For the purpose, we tried to investigate the characteristics of small-scale enterprises and analyzed the pattern of their health care management. The results are as follow: 1. The strength of health managing agency and technical supporting program lies in team approach by specialized manpower. However, if the liaison between each part of the organization is not smooth, the overall management will be very difficult. 2. Small scale enterprises are characterized by their short life after the establishment, use of rental building, lack of welfare facilities, weakness in sanitary management and aggregation of factories of similar type of industry. Because of these characteristics, it is very difficult to solve problem basically, such as improvement of working environment. Therefore, it is important to focus on health education and community based approach. 3. Many workers in small-scale factories are in middle and old age. They have health problems mainly related to personal habits. Implementation of an appropriate health promotion program is needed. 4. The number of workplaces, which should be managed by health managing agent. is increasing rapidly. But the number of health managing agent is limited. In the aspect of the requirement of manpower and equipment, training personal agent is more urgent than founding institutional agent. 5. The uniform method of health management hampers the choice of employer and workers. The types of provision of health management should be diversified. 6. For an efficient management, a frequent visit of personal agent and the following referral to a specialist should be done. The specialists in charge of secondary management are from the field of occupational medicine, occupational hygiene, ergonomics, etc. 7. The health management of small-scale facilities should have six components. They are community-based approach, multi-disciplinary cooperative system, program based on the need of recipient, forming partnership of employer and worker, change of lifestyle, and evidence-based program.

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CRM을 통한 고객충성도에 관한 사례연구 (A Case Study on the Customer Loyalty through CRM: -Focused on the Uzbekistan's Mobile Telecommunication Companies-)

  • 무민 마카모프;김동환
    • 한국산학기술학회논문지
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    • 제7권6호
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    • pp.1356-1363
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    • 2006
  • 본 연구의 목적은 모바일 정보통신 시장에 있어서, 이에 관련한 공급자가 어떻게 성공적으로 기업을 관리함으로써 고객 충성도를 증대시킬 것인가에 대한 것이다. 이러한 목적을 달성하기 위하여 본 연구는 우즈베키스탄의 모바일 정보통신 시장을 사례분석 함으로써 외국의 경우를 고찰하고자 하였다. 본 소고에서는 우선적으로 CRM의 영향력과 제반 요인들이 CRM 시스템을 통하여 고객 이해력에 의한 충성도를 제고시킬 것인가를 분석 검토 하고자 하였다. 고객의 욕구와 고객 만족, 고객 충성도의 관련성들이 어떻게 기업의 수익성과 연계되어 발생하는가는 여러 가지 복잡한 방법들과 관련되어 있는 것으로 나타났다. 본 연구의 특징은 외국의 사례를 중심으로 고객만족과 고객충성도의 관련 속에서 분리한 경우와 결합한 경우의 특성들로 각각 분석 고찰 한 점이다.

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회복기 재활환자의 재입원에 영향을 미치는 요인: 건강보험 청구자료를 이용하여 (Factors Influencing Readmission of Convalescent Rehabilitation Patients: Using Health Insurance Review and Assessment Service Claims Data)

  • 신요한;정형선
    • 보건행정학회지
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    • 제31권4호
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    • pp.451-461
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    • 2021
  • Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.

정신요양 병동에서의 관리영역과 환자의 요양 공간영역의 관찰적 시선에 따른 병동구조와 요양 공간환경의 특성에 관한 연구 (Characteristics of Spatial Environment in Psychiatric Wards through the Analysis by Patient's Preferred Healing Environment in Observational Ward Structure Dividing Staff Area and Patient Area)

  • 주용선
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제27권2호
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    • pp.57-64
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    • 2021
  • Purpose: The relationship between the staff area and the patient's private area is the key factor in designing the structure and the environmental characteristics of ward spaces in a psychiatric hospital. Recent research has found that for the purpose of treatment and securing privacy, psychiatric patients need to be in an open space of relief rather than closed confined environment and under the watch of nursing staffs. Methods: A survey at three kinds of wards in a private psychiatric hospital in Japan was conducted in October 2002. These wards include an acute ward, a psychiatric convalescence ward, and a stress care ward. All three kinds of wards have the same structure. At each ward, spatial preferences of the 145 psychiatric inpatients were surveyed and data concerning the patient's diagnostic category, symptoms, and activities of daily living were recorded. Results: The patients in the stress care ward prefer to stay in private spaces than public spaces. On the other hand, in the acute ward the patients seem to have a preference between managed public spaces where are monitored by nursing staffs and their private rooms where the nurse station is close. In addition, the patients in the psychiatric convalescence ward spend most of their time in the public space, such as the hallways or the day room. Implications: Base on this research, the spaces at the acute ward that could be monitored by the nursing station serves effectively as a safety space for patients was concluded. However, in the stress care ward, the patients may perceive the monitoring by the nursing staff as interruption or nuisance to their relaxation. In order to design an ideal healing environment for psychiatric patients in psychiatric ward, it is important to consider how environmental characteristics of space affect the environmental sense of patients in each ward.

한국 성인의 대사증후군 여부와 치료 유무에 따른 식생활 평가 : 2017년 국민건강영양조사 자료 이용 (Assessment of Nutrient Intake and Dietary Quality of Korean Adults in Metabolic Syndrome Patients According to Taking Medical Care: Based on the 2017 Korea National Health and Nutrition Examination Survey)

  • 이주희;최경숙
    • 대한지역사회영양학회지
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    • 제27권4호
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    • pp.321-340
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    • 2022
  • Objectives: This study established a practical direction for the prevention and management of metabolic syndrome by evaluating the health status, nutrition intake level, and diet quality according to metabolic syndrome and related drug treatment in Korean adults. Methods: The data from the 2017 KNHANES (Korea National Health and Nutrition Examination Survey) was analyzed. The analysis included 2,978 adults, classified into the normal, metabolic syndrome (MetS), metabolic syndrome with medicines (MetS-M), and without medicines (MetS-noM) groups. The nutrient intake, NAR (nutrient adequacy ratio), INQ (index of nutritional quality), and DDS (dietary diversity score) were analyzed. Results: The mean BMI was significantly higher in the MetS group than in the normal group for all subjects. Subjects of the MetS group tended to consume less energy and major nutrients, while males aged 50 ~ 64 and all females showed less intake of nutrients in the MetS-M group. The energy intake ratio was within 55 ~ 65 : 7~ 20 : 15 ~ 30 of KDRI (Korean Dietary Recommended Intake), but the carbohydrate energy ratio of all subjects aged 50 to 64 was over 65%. The NAR of the major nutrients was lower in the MetS-M group, the average INQ was around 0.8, especially the INQ of calcium and vitamin A was less than 1, and the total DDS score was less than 4 points. Conclusions: This study confirmed that the nutrient intake and diet quality differed among subjects diagnosed with metabolic syndrome and managed with medical care. The intakes of energy and many nutrients, the quality of diets, and the diversity of food groups in the MetS-M group were lower than in the normal group. Therefore, these will be an important basis for establishing a specific direction of diet education for preventing and managing metabolic syndrome according to gender, age, metabolic syndrome, and drug treatment.

화상환자의 소양증 관리를 위한 경타법 적용 효과 (Evaluation of the Effects of Self-Managed Percussion Therapy Using Video Education: A One-Group Pretest-Posttest Pilot Study for Burn Patients' Pruritus Management)

  • 김경자;김혜연;서정훈;김도헌;오현진
    • 가정간호학회지
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    • 제30권2호
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    • pp.194-201
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    • 2023
  • Purpose: Post-burn pruritus is one of the most prevalent complications experienced by burn patients. Though medications are prescribed for pruritus, managing this condition can prove challenging. The aim of this research was to develop and disseminate non-pharmacological self-management educational resources, and subsequently evaluate the effectiveness of implementing a percussion therapy approach. Methods: A one-group pretest-posttest design was employed to evaluate the effect of percussion therapy on one hundred patients, all of whom had suffered deep second-degree burns and undergone skin graft surgery. Variables such as the severity of pruritus, distress caused by pruritus, and satisfaction with pruritus treatment were scrutinized. A paired t-test was conducted to compare these variables before and after the intervention. Results: The majority of participants were diagnosed with third-degree burns, and the average Total Body Surface Area (TBSA) affected was 25.2%. Post-test results revealed a marked reduction in both severity and distress caused by pruritus. The intervention led to significant decreases in average severity and pain due to itchiness, and an increase in the satisfaction level following the application of percussion therapy. Conclusions: The implementation of the percussion was identified as effective in diminishing post-burn pruritus, alleviating pruritus-associated pain, and enhancing satisfaction with pruritus treatment. The percussion approach presents itself as a non-invasive, non-pharmacological strategy for managing pruritus in burn patients.

Application of cold atmospheric microwave plasma as an adjunct therapy for wound healing in dogs and cats

  • Jisu Yoo;Yeong-Hun Kang;Seung Joon Baek;Cheol-Yong Hwang
    • Journal of Veterinary Science
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    • 제24권4호
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    • pp.56.1-56.13
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    • 2023
  • Background: Cold atmospheric plasma is a novel innovative approach for wound care, and it is currently underrepresented in veterinary medicine. Objectives: To investigate the efficacy and safety of using cold atmospheric microwave plasma (CAMP) as an adjunct therapy for wound healing in dogs and cats. Methods: Wound healing outcomes were retrospectively analyzed using clinical records of client-owned dogs and cats who were first managed through standard wound care alone (pre-CAMP period) and subsequently via CAMP therapy (CAMP period). The degree of wound healing was estimated based on wound size and a modified wound scoring system. Results: Of the 27 acute and chronic wounds included in the analysis, 81.48% showed complete healing after the administration of CAMP as an adjunct therapy to standard care. Most wounds achieved complete healing in < 5 weeks. Compared with the pre-CAMP period, the rate of wound healing significantly increased every week in the CAMP period in terms of in wound size (first week, p < 0.001; second week, p = 0.012; third week, p < 0.001) and wound score (first week, p < 0.001; second week, p < 0.001; third week, p = 0.001). No adverse events were noted except for mild discomfort and transient erythema. Conclusions: CAMP is a well-tolerated therapeutic option with immense potential to support the treatment of wounds of diverse etiology in small animal practice. Further research is warranted to establish specific criteria for CAMP treatment according to wound characteristics.

심장수술 환자를 위한 전문간호사 주도의 인공호흡기 이탈 프로토콜 적용 결과 (Results of Applying a Ventilator Weaning Protocol Led by an Advanced Practice Nurse for Cardiac Surgery Patients )

  • 임영주;최수정
    • 중환자간호학회지
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    • 제17권2호
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    • pp.42-54
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    • 2024
  • Purpose : This study aimed to assess the effectiveness of an advanced practice nurse (APN)-driven ventilator weaning protocol for patients undergoing cardiac surgeries. Methods : A retrospective analysis was conducted on 226 patients admitted to the intensive care unit (ICU) of a tertiary hospital between January and June 2020, following a cardiac surgery. Patients were divided into an APN protocol-applied group (experimental group, n=152) and a control group managed based on doctors' judgment (n=74). Ventilator weaning criteria and clinical outcomes, including duration of ventilation, length of ICU stay, and rate of reintubation, were compared between the two groups. Results : Patients in the control group were older and had a higher incidence of massive bleeding from chest tube drainage (>100 cc/hr) at baseline. The average duration of ventilation was significantly shorter in the experimental group compared to the control group (7.44 vs. 21.61 hours, p <.001). Furthermore, the mean length of ICU stay was shorter in the experimental group compared to the control group (47.96 vs. 77.97 hours, p <.001). There was no difference in the rate of reintubation between the two groups. Conclusion : These findings suggest that an APN-driven ventilator weaning protocol can improve clinical outcomes without significant complications. These results support the adoption of APN-driven mechanical ventilator weaning protocols in clinical practice.

서울시 학령전기 아동의 근시 유병률과 관련요인 (Prevalence Rate and Factors of Myopia in Preschool Children)

  • 김신자
    • 대한간호학회지
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    • 제35권2호
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    • pp.390-398
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    • 2005
  • Purpose: This study was aimed at providing basic data for developing a nursing intervention program which enables systematic and correct visual acuity care by discovering out visual acuity conditions, prevalence rate of myopia, and the factors related to myopia with Preschool children. Method: The subjects of this study consisted of 519 children between 3 and 6 years of age from 12 kindergartens in Seoul which were selected through multiple cluster sampling. Myopia was defined as the spherical equivalent (SE) of more than -0.5 diopters (D) in the right eye. The data was analyzed by t-test, 2-test, ANOVA, and logistic regression by using the SAS program. Result: The prevalence rate of myopia was $8.7\%$. the odds ratio of child myopia when one parent had myopia was 2.2 times higher than when neither parent had myopia. The odds ratio of child myopia when reading more than three books per week was 0.27 times higher than reading less than three books. Conclusion: Myopia should be continuously and intensively managed from the age of 3.