• 융합정보논문지
• /
• 제12권5호
• /
• pp.150-158
• /
• 2022

본 연구의 목적은 이용자의 관점에서 노인장기요양보험 방문요양서비스 기관 평가의 효과성을 확인하는 것이다. 이를 위해, 전라북도 내 지역별(14개 시·군) 할당표집을 통해 수집한 이용자(266명) 설문자료와 기관(47개) 자료를 결합하여 다층모형으로 분석하였다. 주요 연구결과는 다음과 같다. 첫째, 5개 평가영역 중 이용자에게 권리의식을 갖게하고, 이용자를 존중하는지에 대한 '권리·책임' 영역의 점수가 높을수록 서비스 품질과 만족도도 높게 나타났다. 둘째, 5개 평가영역 중 '권리·책임' 영역과 '급여제공결과' 영역이 충성도에 영향을 미치는 것으로 나타났다. 셋째, '기관운영', '환경·안전', '급여제공과정' 영역은 서비스 품질, 만족도, 충성도에 영향을 미치지 않는 것으로 나타났다. 이러한 결과를 바탕으로 형식적이고 정량적인 평가지표보다는 이용자가 인식할 수 있고, 방문요양서비스의 기본 목적에 충실한 내용으로 평가지표를 재구성할 것 등을 제안하였다.

• 보건행정학회지
• /
• 제29권2호
• /
• pp.228-236
• /
• 2019

Background: This study investigates the impact of weekend admission with a patient safety indicator (PSI) on 30-day mortality among long-term insurance beneficiaries. Methods: Data were obtained from the National Health Insurance Service-Senior claim database from 2002 to 2013. To obtain unbiased estimates of odds ratio, we used a nested case-control study design. The cases were individuals who had a 30-day mortality event after their last medical utilization, while controls were selected by incidence density sampling based on age and sex. We examined the interaction between the main independent variables of weekend admission and PSI by categorizing cases into four groups: weekend admission/PSI, weekend admission/non-PSI, weekday admission/PSI, and weekday admission/non-PSI. Results: Of the 83,400 individuals in the database, there were 20,854 cases (25.0%) and 62,546 controls (75.0%). After adjusting for socioeconomic, health status, seasonality, and hospital-level factors, the odds ratios (ORs) of 30-day mortality for weekend admission/PSI (OR, 1.484; 95% confidence interval [CI], 1.371-1.606) and weekday admission/PSI (OR, 1.357; 95% CI, 1.298-1.419) were greater than for patients with weekday admission/non-PSI. Conclusion: This study indicated that there is an increased risk of mortality after weekend admission among patients with PSI as compared with patients admitted during the weekday without a PSI. Therefore, our findings suggest that recognizing these different patterns is important to identify at-risk diagnosis to minimize the excess mortality associated with weekend admission in those with PSI.

• 한국노년학
• /
• 제30권1호
• /
• pp.1-20
• /
• 2010

본 연구는 '요양보호사 교육과정 경험의 본질은 무엇인가'라는 연구 질문을 가지고 요양보호사 교육과정을 경험한 학습자들과 교육자들의 내적 관점에서 교육과정에 대한 경험을 심층면접을 통해 이해하고자 하였다. 이를 위해 부산 경남 지역의 도립, 대학부설, 그리고 민간 요양보호사 교육기관에서 교육과정을 경험한 12명의 수료생들과 7명의 교강사들에 대한 심층면접 내용을 현상학적 연구방법을 바탕으로 분석하였다. 분석 결과 수료생들의 면접사례에서는 33개의 구성된 의미가 발견되었고, 이들 간의 순서와 관계를 분석하여 최종적으로 15개의 소범주와 다시 4가지 대범주가 발견되었으며, 교강사들의 면접사례에서는 25개의 구성된 의미, 11개의 소범주, 그리고 4개의 대범주가 발견되었다. 즉, 학습자들의 교육과정 경험을 통해서 '막연한 학습동기', '부실한 교육의 양과 질', '교육과정 수료 후의 아쉬움', '개선의 필요성을 절감', 그리고 교강사들의 교육과정 경험을 통해서 '제보다 젯밥에 더 관심을 가지고 온 다양한 수준의 학생들', '부실한 교육의 양과 질', '부실한 행정관리', '개선의 필요성을 절감'의 주제묶음으로 범주화되었다. 결론에서는 요양보호사 교육과정의 개선점을 제시하였다.

• 한국병원경영학회지
• /
• 제20권2호
• /
• pp.28-38
• /
• 2015

This study was conducted by extending Ajzen's Theory of Planned Behavior(TPB) model in analyzing physician's observance behavior of National Health Insurance review standards. An extended TPB model was proposed by including 'background knowledge'and 'dorganizational commitment'in original model to predict physician's review standards observance behavior. Surveys for data collection were carried out on the physicians who were working in a general hospital, clinics, specialized hospitals, local medical centers and long term care hospitals located in Daegu and Kyoung-Buk province in Korea. Two hundreds twenty copies of questionnaires were distributed and 166 physicians responded. Data were analyzed using a structural equation model. The results show that an affirmative attitude and subjective norms have significant positive effects on physicians' behavior of observing review standards. However, the effect of perceived behavioral control on intention to behavior is not significant. The organizational commitment and background knowledge have a positive effect on the intention of observance of review standards. In conclusion, because physician's observance behaviors are affected by background knowledge and organizational commitment as well as attitudes, subjective norms, hospital managements should establish a communication system to share information on the review standards among physicians and provide appropriate measures to increase physician's organizational commitment.

• Bulletin of the Korean Chemical Society
• /
• 제33권12호
• /
• pp.4267-4270
• /
• 2012

• 한국산학기술학회논문지
• /
• 제14권7호
• /
• pp.3390-3399
• /
• 2013

본 연구는 2009년 한 해 동안 건강보험심사평가원의 요양급여 전체 청구자료를 통계적으로 표본 추출 한 환자표본자료를 이용하여 의료기관 종류 별 욕창 발생현황과 이중 요양병원 환자의 욕창 발생에 영향을 주는 요인을 규명하기 위해 시도되었다. 전체 의료기관 입원환자의 3.2%(n=25,339)에서 욕창이 발생하였다. 의료기관 종별로는 요양병원 입원환자의 8.2%(n=11,895)에서 욕창이 발생하여 종합병원(2.7%, n=8,052), 일반병원(1.7%, n=5,059) 보다 상대적으로 높은 비율을 보였다. 요양병원 입원환자(n=144,523)의 욕창발생에 영향을 주는 요인을 분석한 결과 의학적 진단 중 요실금을 가진 환자 군이 가지지 않은 군에 비해 욕창 발생이 2.46배 유의하게 높게 나타났다(Odds ratio(OR)=2.462, 95% confidence interval(CI)=2.038-2.974). 더하여, 고혈압질환(OR=1.456, CI=1.400-1.515), 말초혈관 질환(OR=1.357, CI=1.200-1.534)군 순으로 욕창 발생에 영향을 미쳤다. 진단 수(OR=1.193, CI=1.187-1.199)와 나이(OR=1.011, CI=1.009-1.012) 및 100침상 당 의사 수(OR=1.063, CI=1.035-1.091)가 증가할수록, 의료기관의 전체 침상수(OR=.889, CI =.869-.909)가 적을수록 욕창발생은 유의하게 높은 것으로 나타났다.

• 보건행정학회지
• /
• 제28권3호
• /
• pp.217-221
• /
• 2018

Korea Institute for Family Planning (KIFP) was established on July 1, 1971 (Law 2270) and Korea Health Development Institute (KHDI) was established on April 19, 1976 (Law 2857). Korea Institute for Population and Health (KIPH) was formed through the merger of KIFP and KHDI (Act 3417) on July 1, 1981. Korea Institute for Health and Social Affairs (KIHASA), the former KIPH, was renamed KIHASA on December 30, 1989 (Law 4181) with its additional function of research in social security. It was transferred on January 29, 1999 to the Office of State Affairs Coordination pursuant to the Law on the Establishment, Operation and Promotion of State-Sponsored Organizations (Law 5733). Annually it conducts approximately 50 short- and long-term research projects to accumulate a wide range of research experience. Also it studies and evaluates the primary issues of national health services, health and medical industries, social insurance, social security, family welfare, and population. it conducts joint research projects and active information exchange programs with related domestic and international organizations through seminars and conferences. It executes specific research and development projects according to the government's requests. it educates and trains people domestically and abroad by disseminating a wide-range of information on health and social affairs. it conducts national household surveys on areas of fertility, health and medical care of the disabled, the elderly, and low-income earners. The mid- and long-term research goals of KIHASA should be established and managed systematically. A new organization such as 'Center for Policy Evaluation' is needed to enhance research abilities and experiences. Able research personnels should be recruited and current researchers should try to develop their abilities.

• 의학교육논단
• /
• 제24권1호
• /
• pp.10-17
• /
• 2022

South Korea is not a wasteland of publicly funded health care-instead, it has a good medical social security system known as the national health insurance (NHI). The NHI of Korea has three unique features; (1) low premiums, low insurance fees, and low coverage; (2) obligatory designation of medical institutions; (3) and allowance of non-benefit services. These features have made hospitals and doctors interested in profit-seeking. However, the commercialization of medical institutions has taken place in both private- and public-established sectors. A basic problem of commercialization is the co-existence of the obligatory designation of medical institutions and non-benefit services. The problem became worse in the Kim Dae-Jung government because it officially permitted non-benefit services. Since 2000, the Korean government has consistently pursued benefit extension policies, but the coverage rates of the NHI have stagnated. In addition, premiums and current medical expenses have markedly increased because policy-makers have emphasized accessibility to the NHI, while ignoring important principles of medical social security such as a needs-based approach and patient-referral system. In order to resolve the commercialization problem, the obligatory designation of medical institutions to the NHI should be changed to a contract system, and non-benefit services should be prohibited at NHI institutions. We must re-establish the patient-referral system via a needs-based approach. We also need to build a primary healthcare system and public health policies. We should make a long-term plan for healthcare reform.

• 기본간호학회지
• /
• 제17권1호
• /
• pp.73-81
• /
• 2010

Purpose: This study was done to identify the intensive care unit nurses' knowledge of and compliance with the standard precautions (universal precaution) as stated in infection control guidelines. Method: From September 14 to September 28, 2006, data were collected via a questionnaire survey from 189 Intensive Care Unit nurses working at three university branch hospitals and one general hospital in Gyeonggi province. Results: The mean knowledge score was 18.8/20.0 (93.9%). The mean compliance score was 3.4/4.0 (85.8%). Two factors influencing compliance were perception of the standard precautions and experience of needle stick injuries over the past year (p<.05). Two factors influencing knowledge were support of co-workers in the use of protective devices and the availability of hand-washing device or waterless alcohol gel (p<.05). Conclusion: In order to improve knowledge and compliance with standard precautions, all factors of importance for knowledge and compliance must be taken into consideration in the clinical work place and in education.

• 지역사회간호학회지
• /
• 제27권1호
• /
• pp.1-8
• /
• 2016

Purpose: The purpose of this study was to examine the depression and cognitive function of community-dwelling older adults. Methods: 243 aged over 65 in Won-Ju in South Korea participated in this study. Data were collected from April to June 2013 through interviews. This study utilized the Geriatric Depression Scale Short Form, the Korean version of MMSE-DS (MMSE for Dementia Screening), and infirmity testing for basic health status. Descriptive statistics, ${\chi}^2$, t-test, ANOVA, $Scheff{\acute{e}}^{\prime}s$ test, and Pearson's correlation coefficient were used. Results: 75.3% of the participants belonged to the depression group, and the prevalence of cognitive impairment was 17.3%. There were significant differences in depression and cognitive function according to gender, educational level, type of insurance, subjective health, frailty, and whether to be a client of home care service. The level of depression was significantly higher and the level of cognitive functions was significantly lower in older adults in home care services than in community-dwelling older adults. Conclusion: This study is meaningful in that it included older adults in home care services to provide information to develop effective prevention programs for improving cognitive functions. The results of this study can be used to develop future community prevention and intervention.