• 임상간호연구
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• 제29권3호
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• pp.312-326
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• 2023

Purpose: This study attempted to analyze the staffing level and critical care nursing fees of intensive care units at tertiary and general hospitals and to provide a professional judgment-based recommendation on staffing level and critical care nursing fee schedules. Methods: Staffing grades and critical care nursing fee schedules for the first quarter of 2017~2020 and the fourth quarter of 2020~2022 were analyzed. A survey was conducted on nursing managers and nurses about the current and appropriate staffing levels. A total of 77 nurse managers and 708 nurses working in Intensive Care Unit(ICU)s at tertiary and general hospitals participated in the study. Results: Grade 1 staffing increased from 25.6% in 2017 to 92.1% in 2022 at tertiary hospitals and from 0.8% in 2017 to 28.4% in 2022 at general hospitals. The current staffing ratios of tertiary and general hospitals were 1:2.21 and 1:2.77, respectively. The appropriate staffing ratio according to nurse managers and nurses was 1:1.00 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in tertiary hospitals, and it was 1:1.25 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in general hospitals, respectively. Conclusion: The appropriate staffing level was suggested from 1:1.0 to 1:2.0. The new nursing fee schedules were suggested from 1:1.0 (Grade 1) to 1:3.0 (Grade 5) and recommended to be paid based on the staffing grade, minimum number of nurses, and standard annual working days. It is expected to increase staffing levels and provide a better nursing work environment.

• 한국약용작물학회지
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• 제22권6호
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• pp.475-482
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• 2014

This study was indicated to enhance the anti-inflammation activities by the fermentation of the fruits of Aronia melanocarpa (Michx.) Elliott. The extracts by 70% ethanol (EE) showed better biological activities than those by hot water (WE) from campared result of the effect of extraction solvents. Then, the extract from 70% ethanol extraction was further fermented by lactic acid, denoted as FEE. For antioxidant activities, the FEE had showed the highest value as 0.832 of reducing powder, in comparison with those of EE and WE. Cytotoxicity of the water extraction (WE) was measured for 12.06% in addition of $1.0mg/m{\ell}$ of FEE. For anti-inflammation activities, NO production from the macrophage, RAW 264.7 was observed as $7.24{\mu}M$ and $8.52{\mu}M$ from FEE and EE, respectively. Prostaglandin $E_2$ ($PGE_2$) production from human fibroblast cell, CCD-986sk, was also estimated for $152pg/m{\ell}$ in addition of $1.0mg/m{\ell}$ of the FEE. The lowest production of both IL-6 and TNF-${\alpha}$ were $3.5pg/m{\ell}$ and $865.5pg/m{\ell}$, respectively in addition of $1.0mg/m{\ell}$ of the FEE, whereas $74.5pg/m{\ell}$ and $982.4pg/m{\ell}$ in treated with same concenrations of the EE. It was also found that the FEE was higher amounts than other extracts through HPLC analysis of the anthocyanins. These results strongly indicate that fermentation process of the lactic acid could enhance anti-inflammation activities of extracts by increasing the amounts of the anthocyanins, especially cyanidin-galactoside. Our results suggest that the application of the fermentation process for other medicinal herbs can be improved their biological activities.

• 대한화장품학회지
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• 제39권4호
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• pp.303-311
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• 2013

본 연구에서는 소염, 항염 작용이 뛰어난 작물로 알려진 황금을 유산균인 Lactobacillus rhamnosus를 이용해 발효를 통한 황금의 추출물에 대한 추출공정별 항염증 효과 증진을 측정하였다. 추출 공정으로는 일반열수추출(WE), 일반 70% 에탄올 추출(EE), L. rhamnosus 발효 열수 추출(FWE), L. rhamnosus 발효 70% 에탄올 추출(FEE)로 나누어 진행하였다. 각각의 추출 공정별 수율 측정결과 발효 70% 에탄올 추출이 25.9%로 최대 수율을 얻었으며, 발효 열수 추출, 일반 70% 에탄올 추출, 일반 열수 추출 순으로 높은 수율을 얻었다. 추출 공정별 세포독성 측정에서 발효 황금 에탄올 추출물의 농도가 1.0 mg/mL일때 9.8%로 가장 낮은 세포독성을 나타냈으며, 일반 에탄올 추출의 경우 22.6%로 가장 높은 세포 독성을 가졌다. Hyaluronidase 저해 효과는 발효 황금 에탄올 추출물의 농도가 1.0 mg/mL에서 최대 46.8%의 hyaluronidase 저해 활성을 보였으며, NO 생성량 및 $PGE_2$ 생성량 측정도 1.0 mg/mL 농도의 발효 황금 에탄올 추출물이 각각 36%의 최대 NO 생성량 감소 및 810 pg/mL의 낮은 $PGE_2$ 값을 나타냈다. 따라서 황금의 항염증 관련 효과를 위한 최적 추출 공정으로는 발효를 통한 황금의 70% 에탄올 추출 수율이 가장 높았으며, 이에 따라 항염증 관련 생리활성 물질이 보다 더 많이 용출됨을 확인할 수 있다.

• 대한간호학회지
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• 제36권3호
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• pp.503-513
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• 2006

Purpose: This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes. Method: The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies. Result: The cost of home health care nursing per visit was calculated as 50,626\. This was composed of a basic visiting fee of $35,090{\\}({\fallingdotseq}355$)$ and travel fee of $15,536{\\}({\fallingdotseq}15$)$. The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services. Conclusion: This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

• 여성건강간호학회지
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• 제17권4호
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• pp.328-336
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• 2011

Purpose: The purpose of this study is to develop the optimal nursing fee for nurse-midwifery center (MC) in the national health insurance system. Methods: The three methodologies used to calculate the conversion factors for the MCs in the national health insurance include cost accounting method, sustainable growth rate (SGR) model, and index model. In this study, the macro-economic indicators and the national statistics were used to estimate the conversion factors for the MCs. Results: The optimal nursing fee for the MCs in 2011 was estimated to be an increase of 57.7% by cost accounting analysis, a decrease of 17.1% by SGR model, and a decrease of 16.1% by index model. The results from SGR model and index model could had been biased due to the upswing of medical spendings in the short-term period (2008~2009). A sensitivity analysis of pre-delivery subsidy program for OB & GYN hospitals and clinics showed that the program has substantially diminished the demand for the MC services. Conclusion: More reliable methodologies to estimate nursing fees precisely are required to prove the value of nurses' services and a government subsidy program for the MC services should be followed from a social perspective.

• 간호행정학회지
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• 제9권3호
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• pp.379-389
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• 2003

Purpose: The objective of our study was to figure out costs of nursing services in general nursing units based on the PCS in order to determine an appropriate nursing fee schedule. Method: The data were collected from 8 hospitals from September 9 to October 8, 2002. The costs of nursing services in general nursing units was analyzed by nursing hours based on the nursing intensity. The inpatient in the general nursing units were classified by Park's PCS tool(2000). Results: The distribution of patients by PCS ranged from class I to Class III in general nursing units. The higher PCS in general nursing units consumed more nursing hours. As a result, the higher nursing intensity, the more the daily average nursing costs in general nursing units. Conclusion: We found that the higher PCS, the more the daily average nursing costs in general nursing units. In conclusion, our study provides the evidence to refine the current nursing fee schedule that it does not differentiated from the volume of nursing services based on the nursing hours.

• 대한간호학회지
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• 제48권5호
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• pp.554-564
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• 2018

Purpose: This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process. Methods: Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology. Results: The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period. Conclusion: The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.

• 한국치위생학회지
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• 제11권2호
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• pp.275-289
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• 2011

Objectives : The recognition rate for issues and improving resolution for the recuperation income expense claim policy was examined. Methods : 1,135 copies of survey have been sent to the group of people who have claimed the dental recuperation income expense to dental recuperation institutions in Daejeon, Chungcheong Do that are registered to the health insurance evaluation and estimation office as of the May 2010 and 207 surveys that were regarded to be sincere for answering were analyzed. Results : Majority of respondence were belonged to the dentist institutions with more than 5 years of claim experiences as well as 10~50% of claim rate. The recognition of medical fee evaluation guideline was normal level, and negative recognition was higher to the health center with daily charge policy compare to the dental hospital and university affiliated dental center with treatment charge policy, Highest opinion for inappropriateness of dentist with significance was found (p<0.05). The openness of evaluation cases are regarded to be discharged through the transparent evaluation and most of the opinions for insurance claim evaluation adjustment are within the both 'Do not understand the evaluation guideline and program error of disease category, code and program' with significance(p<0.05). The reaction after the evaluation adjustment was high in reflection on the claim process after examining the reason for the evaluation adjustment through the evaluation and estimation office and university affiliated dental institution and dental center was regarded to be most active and deputy reclaimment was seemed to be most actively discharge the objection registration task (p<0.05). The claim error improving resolution recognition was highly prioritized to the accurate charting for the disease title and treatment description, improving the setting of claim program, and most highly recognized by the university affiliated dental hospital/dental center and comparably low by health center(p<0.05). and although the most of the responds of treatment description and browsing the medical fee was positive, 50% of dentists disagreed the idea so that this was creating a significant discrepancy with other groups(p<0.05). Conclusions : From this research, the recognition of medical fee evaluation guideline for dental (university) hospital and dentists were negative and high adjustment experience was examined as lacking of evaluation guideline understanding and error of disease name, code and programs and deputy reclaimment, university affiliated dental hospital/dental center were most actively handle the objection registration tasks and dentists have objection on the treatment description and browsing the treatment fee so that if these indexes can be referred to implement into the recuperation income claim process, this can be regarded to be a opportunity to create mutual credibility between recuperation institution, treatment pensioner and the evaluation institutions.

• 대한물리치료과학회지
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• 제5권1호
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• pp.557-571
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• 1998

The purpose of the study is (i) to investigate the operating situation of physical therapy department in public health centers, (ii) to analyze the difference of elderly satisfaction from non-elderly satisfaction of physical therapy services among the public health center visitors, and finally (iii) to suggest facilitating improvement on programs that can supply the elderly health service through public health centers. A questionnaire survey was carried out 212 patients of 25 public health center in Seoul, Korea from 15 July to 10 August 1996. Major results of the study are as follows : 1. Among the respondents. the largest group was the elderly who are over 65 years old (72.6%). 2. The averge of general patients' satisfaction for physical therapy services was 3.98, especially fee of treatment(4.76), attitude of physical therapist(4.33), and reliance of physical therapist(4.20) were higher by 5-score Likert scale. 3. The correlation factors with general patients' satisfaction were process of treatment (r =.6301). results of treatment(r=. 6186), and guide facilities(r=.5999). 4. The results of multiple-regression analysis between general patients' satisfaction and affecting factors identify following variables as the statically significant determinants : general stisfaction comparing with other physical therapy services, physical therapy services using forwardly, fee of treatment. 5. There was no significant defference between elderly and non-elderly patients' satisfaction of physical therapy service, except attitude of physical therapist(t=-2.07), explanation of treatment for disease(t=-2.19), fee of treatment(t=6.29).

• 한국생활과학회지
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• 제11권1호
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• pp.95-106
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• 2002

This study was done to investigate the perception and need of the nutrition counseling of the people living in Daejon. Results were as follows: Nutrition knowledge score increased with education level. It showed tendency that women's scores were higher than men's. Only 15.5% of the participants were experienced in nutrition counseling mostly with medical doctor or nurse in the general hospital. Their satisfaction level was above average, which means positive reaction on nutrition counseling. In the case of the people who paid nutrition counseling fee, they thought that fee level was reasonable. Participants whose education level was higher thought less frequently that the nutrition counseling fee charged currently in the general hospital was expensive. The prevalent contents they want in the nutrition counseling included the prevention and the treatment of the specific disease and food safety (pesticides and food-born illness). As means of nutrition counseling they preferred internet (or PC) and interview. The higher the education status and the less the age, the higher preference, there was for internet or PC. As a source of nutrition knowledge, participants gave high credit on the professional books, academic journals, and advices from dietitian, nutritionist, medical doctor and pharmacist; in the other hand, they gave low credit on the newspaper, magazine, TV or radio, and advices from family or relatives, and friends. They thought most of the adult-onset disease (especially obesity, hyperlipidemia, and diabetes) were closely related to diet. However, percentage of the participants who thought that diet and kidney disease were related was relatively low.