• 제목/요약/키워드: post operational care

검색결과 10건 처리시간 0.011초

임상가를 위한 특집 1 - 성공적인 선 수술 교정 치료를 위한 고려사항 (Clinical considerations for successful results in FOS(Functional Orthognathic Surgery): Surgery first orthodontic treatment later)

  • 오창옥
    • 대한치과의사협회지
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    • 제50권2호
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    • pp.58-63
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    • 2012
  • The fundamental principles and the role of surgeons and orthodontists to produce successful results in orthodontic treatment combined with orthognathic surgery is not different from those of conventional procedures and FOS: surgery-first-orthodontic-treatment-later approach. The communication and cooperation between surgeon and orthodontist is of crucial importance. In FOS, the pre-surgical orthodontic preparation is not carried out in the patient's mouth, but in the mounted stone model and in addition to the simulation of tooth movement, to get a precise surgical occlusion, the entire steps of treatment should be simulated on the articulator as well. Right after the surgery, due to the instability of the occlusion, appropriate post operational care should be given according to the surgical technique applied to the mandible by use of final surgical wafer about 8 weeks.

Relationship between Hospital Case Mix and Costs and Incomes of Tehran Heart Center

  • Langroudi, Hamed Rahimpour;Kakhani, Mohammad Jamil;Hojabri, Roozbeh
    • Asian Journal of Business Environment
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    • 제7권3호
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    • pp.17-22
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    • 2017
  • Purpose - Clarifying one of the biggest public Hospital Costs and incomes according to patients' case mix. It leads to prepare financial information about pubic medical tariffs and hospital operational costs. Research design, data, and methodology - This study calculates the costs both, with and without taking into account capital costs. This holds for comparison of hoteling based on case mix in all medical procedures. The checklists were reviewed and filled by reviewing accounting documents of the hospital, warehouse exclusion list, and daily books of laundry and CSR. Data was analyzed descriptively by using Excel. Results - In both cases, the hospital is losing in terms of hoteling. Because the buildings and equipment are new, this loss is not tangible. However, this will be revealed when costs of reconstruction and replacement of equipment. The loss rate per day of hospitalization was 569318 Rials for Coronary Care Unit (CCU), 528171 Rials for Post Intensive Care Unit (Post ICU), 474570 Rials for ICU, 233183 Rials for Post CCU and 204803 for Surgical ward. Conclusions - Income of hoteling was lower than its costs. ANOVA showed a strong relationship between case mix and hospital costs as well as case mix and its income. This suggests that optimal case mix can minimize the costs and maximize income.

보건 진료원 제도 운영 평가에 관한 연구 -우리나라 1차 보건의료 제도 방향 재설정을 위하여 - (A Review of the Operation Community Health Practitioner System as a Reorientation of Primary Health Care)

  • 홍여신;이인숙
    • 대한간호학회지
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    • 제24권4호
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    • pp.568-583
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    • 1994
  • In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.

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한국 건강보험법 시행 30년의 역사와 과제 (Overview and Insight After 30 years of implementing the National Health Insurance Regulations in Korea)

  • 신언항
    • 의료법학
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    • 제8권2호
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    • pp.9-35
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    • 2007
  • The Health care program in Korea has now been systemized after 30 years of declaring the inauguration of the national health insurance system by the current government. The national health care covering all Korean citizens was achieved after 12 years of implementing the national health insurance and the health care program since 1977. Hundreds of multiple operational agencies managing the insured individually had undergone the amalgamation process from 1998 to 2000, and had been restructured as one agency, the National Health Insurance Corporation. In 2003, the community/area based financial management was also merged together with the employment based financial management. The National health care system of Korea offer various merits, compared with that of other countries, such as health care provision covering all Koreans, low insurance premium, accessibility of medical services/facilities etc. However, there are still some weak features which need to be addressed for improvement; below expectation insurance cover system, mistrust on the medical services, low medical charges resulted from excessive restrictions, and unstable financial status of the national health insurance etc. Therefore, the National health care system should continue to evolve to re-establish itself as more effective national health care system by further strengthening its merits, and by improving its weaknesses; with adopting the positive system to optimize the costs of prescribed medicines/drugs, applying simpler insurance coverage system to calculate the optimum medical charges, promoting private medical insurances, and increasing insurance premium etc.

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CD ROM을 이용한 교육프로그램이 단기입원수술 환자의 수술 전 불안과 수술 후 자가간호 수행을 위한 지식에 미치는 효과 (The Effects of Nursing Education using CD ROM on the Anxiety and Knowledge of Patients having Minor Surgery)

  • 황연자;박연환;박인선;김남이;김정미;김진영
    • 성인간호학회지
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    • 제16권1호
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    • pp.82-89
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    • 2004
  • Purpose: The purpose of this study was to investigate the effect of nursing education using a CD ROM on the anxiety and knowledge of the patients having minor surgery. Method: Forty patients hospitalized in K hospital in Seoul from April to August 2002 participated in this study. In the experimental group, twenty patients received nursing education on the operational procedures and post-operational care. The control group, received conventional nursing care only. Anxiety experienced by patients was measured by Spielberger's State-Trait Anxiety Inventory, and knowledge was measured by an instrument developed by Rahe et al. The data were analyzed by SPSS statistical program. Result: There were no significant differences in anxiety level between two groups. However, subjects in the experimental group were found to have significantly higher postoperative knowledge levels than those in the control group, and were very satisfied with the CD ROM program. Conclusion: The nursing education program using CD ROM before minor surgery proved to be an effective nursing intervention to increase knowledge of patients and contribute to their self care after discharge. To decrease anxiety of the surgery, the nursing education program should be combined with supprortive emotional nursing intervention, such as touch, and massage.

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근력강화 순서도를 활용한 운동 프로그램이 농촌 여성노인의 유연성, 악력, 우울에 미치는 영향 (Effect on Exercise Program using Muscle Strengthening Flowchart on Flexibility, Hand Strength and Depression in Rural Elderly Women)

  • 손계순
    • 한국농촌간호학회지
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    • 제9권1호
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    • pp.19-32
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    • 2014
  • Purpose: The strudy was done to determine the effect of an exercise program using the muscle strengthening flowchart on flexibility and hand strength and depression of rural elderly women. Methods: For 11 months, from January 9, to November 29, 2013, a survey was done of 37 voluntary participants who were elderly women living in rural areas. This study was a one group pretest-posttest Quasi-experimental research design to identify the effectiveness of self-directed programs. The Korean version of the depression measurement tool (Jo and Kim, 1993) was used. The collected data were analyzed using frequency, descriptive statistics, and paired t-test with SPSS /PC 17.0 program. Results: Comparison of before and after the self-directed program showed that flexibility (p <.001), left grip strength (p <.001), and right grip strength (p <.001) were significantly increased. Depression (p <.001) was significantly reduced. Conclusion: The results of the study show that the exercise program using the muscle strengthening flowchart resulted in of significant muscle strengthening and reduction in depression in rural elderly women. Future use of the muscle strengthening flowchart is recommended to provide long-term operational exercise programs.

어린이집 운영의 공공성에 영향을 미치는 요인 (A Study on the Factors of Operational Publicness of Child Care Centers)

  • 양미선
    • 한국보육지원학회지
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    • 제10권3호
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    • pp.31-46
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    • 2014
  • 본 연구의 목적은 어린이집 유형별 공공성 수준 차이를 살펴보고, 공공성에 영향을 미치는 어린이집 특성을 알아보는 데 있다. 구체적으로, 어린이집 운영의 공공성 구성요소별 수준을 파악하기 위한 문항을 개발하고, 이를 통해 어린이집 유형별 차이를 살펴보았으며, 어린이집 운영의 공공성에 영향을 미치는 요인을 규명해 보고자 하였다. 연구대상은 어린이집 총 511개소로, 국공립어린이집 108개소, 법인어린이집 110개소, 민간어린이집 101개소, 가정어린이집 80개소, 공공형어린이집 121개소이다. 자료 분석을 위하여 빈도, 백분율, 평균, 표준편차, F검증, Duncan 사후검증, 중다회귀분석을 실시하였다. 연구결과는 첫째, 국공립어린이집이 보편성, 참여성, 투명성이 가장 높고, 공공형어린이집은 공개성이 가장 높았다. 반면에 민간과 가정 어린이집은 모든 공공성 구성요소에서 가장 낮은 수준을 나타내었다. 둘째, 어린이집 운영의 공공성 구성요소, 즉 보편성은 국공립어린이집과 대도시나 중소도시에 소재할수록 높았고, 공개성은 반대로 법인, 민간, 가정 어린이집일수록 낮았으며, 투명성과 참여성은 국공립과 법인 어린이이며, 정원충족률이 높을수록 높았다. 어린이집에 대한 지원 확대와 이에 대한 정부의 관리감독이 수반되며, 어린이집 운영의 공공성 확보를 이룰 수 있음을 시사하였다.

진료재료대 수가누락방지 및 비용절감 개선활동 (Prevention of Missing the Fee of Medical Supplies and Improvement Activity of Cost Cutting)

  • 최현주
    • 한국의료질향상학회지
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    • 제21권1호
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    • pp.52-61
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    • 2015
  • Objectives: Because recently hospital had to faced with financial hardship, we have to have more effective hospital management. The purpose of this study was to reduce loss costs of the hospital through the systematic management of medical supplies and increase operational efficiency. Methods: The team was composed of outpatient nursing staff, medical record administrator, nurses in medical insurance, medical computer center, dermatologists for this study. We surveyed for 114 people including outpatient nursing staff, nurse aids, medical assistant, physician assistant. Pre-survey period was 2013.03.11 ~ 03.30(2 weeks), and post-survey period was 2013.09.03 ~ 09.17(2 weeks). Result: We improved this way through the computational improvement, conservation campaigns, inventory management, staff training, replaced by low-cost medical supplies. The finding of this study were as follows: Comparing before and after the activity of outpatient nursing staff's degree of knowledge, performance, economic consciousness, the degree of knowledge, performance was increased, but there was no significant change in economic consciousness. Performance of Married person is higher than the unmarried, In addition, the high-position people were more the degree of knowleage, economic consciousness. After activity, correlation of goods and treatment, examinations is increasing, but statistically there was no mean. Conclusion: This study revealed that knowledge in a short period of activity, but also can improve, perform the same change in behavior is not easy. This one shows the intensive training required to sustained and systematic behavioral changes, such as changes in behavior, perform rituals to help the economy. Expensive medical supplies to replace a similar effect as the cost of materials just to have a lot of cost savings. Therefore, more medical supplies change is necessary to develop alternative treatment and cost cutting.

영유아 교육·보육 통합시설의 필요 공간과 면적기준에 관한 연구 (A Study on the Necessary Spaces and Area Standards of Integration Facility for Early Childhood Education and Care)

  • 조진일;최형주
    • 교육녹색환경연구
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    • 제17권2호
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    • pp.22-37
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    • 2018
  • 본 연구는 '유치원 어린이집 간 격차 완화'를 위한 하나의 방안으로 '교육시설 질 균등화'를 위해 우선적으로 영유아 교육 보육 통합시설이 갖추어야 할 필요공간과 면적기준(안)을 제시하는 데 목적을 두었다. 그 결과 첫째, 영유아 교육 보육 통합시설에 필요한 공간의 종류를 표15와 같이 반드시 필요한 필수공간과 교육 보육 활동의 질적 수준을 높이기 위해 추가되면 좋을 권장공간으로 구분하여 제시하였다. 둘째, 영유아 교육 보육 통합시설의 필요 공간별 면적기준(안)을 표23과 같이 제시하였다. 아울러 영유아 교육 보육 통합시설에 필요한 영유아 1인당 대지면적과 연면적, 연면적 대비 공용면적의 비율을 각각 제시하였다.

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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