• 한국병원경영학회지
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• 제9권1호
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• pp.46-65
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• 2004

The study was designed to investigate what effect of working time reduction which will be gradually expanded to corporate size from June, 2004 could give to medical industries, and to provide basic information for hospitals and government to prepare the policy. 276 hospitals were surveyed about medical service income and manpower realities during the first half of 2003, using a structured survey tool. Response rate was 8% and 20 hospitals were finally analyzed. The effect of working time reduction in hospital management was different to the size of hospitals and the alternative. Income to existing service income was decreased by $2.2{\sim}4.6%$ in tertiary hospitals, by $3.2{\sim}5.7%$ in general hospitals with more than 300 beds, and by $3.7{\sim}6.0%$ in general hospitals with less than 300 beds. In preparation against such decrease in income, government is required to raise insurance payment, to calculate added service charge for day-off on Saturday forenoon, to retain emergency care payment, to expand emergency care facilities, to secure duty doctors, and to support middle and small sized hospitals. Hospitals are required to give self improving efforts such as fortifying of weekday care, development of weekend care program, strengthening of care capacity and function of emergency care center, and making manpower operation efficient.

• 부모자녀건강학회지
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• 제7권1호
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• pp.73-88
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• 2004

Purpose: The Purpose of this study was to analyze the trend of research related with unmarried mother. Method: 81 theses about unmarried mother from 1972 to 2003 were analyzed according to the theses' characteristics, sources by publication period, research design, nursing intervention effect of experimental study and theme of qualitative research. Results: 1. The number of studies related with unmarried mother has progressively increased by year from 1972, and that of theses was highest during the period between 2000 to 2003. 2 As for study design, the number of quantitative studies were 73 and that of qualitative studies were 8. The majority of research design were survey and correlational studies. 3. Nursing intervention used in the experimental design were stress management program, eco-system support group, group art treatment, career education program, musical activities, prenatal education. All of experimental design were used in the after 2000. 4. The themes of qualitative studies were childbirth experience, a participatory on the life, mother's keeping a child, experience of pregnancy and delivery, the self-group program, the process and experience of becoming unmarried adolescent mother, needs of single mothers with child and policy of social welfare service, lived experience of hope. All of these were used in the after 1999. Conclusions: The summary of the above results shows a tendency that the study has increased by year. Especially, experimental study proved affirmative effect. However, for the unmarried mother, more experimental and qualitative studies are to be required.

• 한국노년학
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• 제37권3호
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• pp.727-745
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• 2017

본 연구는 중고령층에서 초기노년층의 주관적 건강수준의 변화양상과 그 격차를 결정짓는 요인으로 불안정 고용(precarious employment) 및 고용상태 관련 요인의 영향력을 살펴보고자 하였다. 또한 공적 및 사적 사회적 자본이 중고령기에서 초기노년기에 이르는 주관적 건강상태의 격차를 완화시킬 수 있는지 알아보고자 하였다. 이를 위하여 한국노동패널조사(KLIPS) 6차~17차년도 자료를 사용하였고, 다수준 성장곡선 모형(Multi-level growth curve modeling)을 고정효과(fixed effects) 모형과 확률효과(random effects)모형으로 STATA 13.0을 사용하여 추정하였다. 또한 두 모형을 기반으로 한 가설검정을 위해 하우스만 검정을 수행하였다. 연구결과는 정규직에 비해 일용직이 시간에 따른 주관적 건강상태의 변화를 악화시키는 요인으로 나타났으며, 임금, 고용상태의 질(근로시간), 사적/관계적 사회적 자본이 중고령기에서 초기노년기에 이르는 건강격차를 설명할 수 있는 주요 요인으로 나타났다. 이러한 결과를 기반으로 '확산 가설'과 '누적되는 이익' 가설을 지지하고 있으며, 중고령기에서 초기노년기에 이르는 건강불평등을 완화시킬 수 있는 고용지원 정책 및 사회적 서비스 개발 방향을 제시하고 있다.

• 한국보건간호학회지
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• 제31권2호
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• pp.284-295
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• 2017

Purpose: This study was conducted to compare the hypertension management between a non-elderly group and elderly group of hypertension patients in Community residents. The study also sought to generate strategies for increasing the hypertension management of residents using Community health center. Methods: Data on the general characteristics and hypertension management from 381 hypertension patients between non-elderly and elderly, living in P city, Gyeonggi Province and C city, Chungnam Province. South Korea, were collected based on a structured questionnaire, The data were analyzed using the SPSS 20.0 statistics program. Results: The use of a Community health center in the non-elderly and elderly groups showed a statistically significant difference in facility excellence and cheaper cost. Hypertension management was measured every day, The daily blood pressure and physician counseling was performed according to the changes in blood pressure. The management of hypertension medication in a community health center provided for hypertensive patients can be evaluated as an efficient service. Conclusion: The self-management ability of hypertension needs to be improved. In particular, especially, the elderly managed by the Community health center have good accessibility and a good alternative for the treatment cost. Therefore, it is necessary to provide support and measures to make hypertension management safer.

• 보건교육건강증진학회지
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• 제27권5호
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• pp.51-61
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• 2010

목적: 본 연구는 요양보호사 교육 수료생들을 대상으로 요양보호사의 업무 인지와 요양보호서비스 대상자 인지 정도를 예측변인들을 통해 검증함으로써 요양보호사가 인지하는 직업의 전문성 정도를 파악하는 것을 연구목적으로 한다. 방법: 응답자가 직접 기입하는 '자기기입식질문지법'을 이용하였고 불성실 응답 및 다문항 미기재 설문지를 제외한 총 2백83부를 분석에 사용하였다. 관련요소들의 기술적 통계를 통해 요양보호사 업무에 대한 인지 정도 및 서비스 대상자의 특성에 대한 인지 정도를 살펴보았다. 그리고 위 두 변수와 관련 요소들간의 상관관계를 알아보고, 어떠한 요소가 요양보호사 업무에 대한 인지 정도 및 서비스 대상자의 특성에 영향력을 갖는지 알아보기 위하여 다단계회귀분석을 실시하였다. 결과: 요양보호사 업무 인지에 관한 단계적 회귀분석에서 요양보호사는 전문직업이다(${\beta}$=.300)와 업무 특성에 관한 지식을 갖고 있다(${\beta}$=.254)가 유의미하게 나타났다. 또한 요양보호서비스 대상자 특성에 관한 단계적 회귀분석 결과로 가족들의 지지(${\beta}$=.187)와 요양보호사 업무인지 정도(${\beta}$=.509)가 유의미한 변인으로 밝혀졌다. 결론: 이상의 결과를 통해 본 연구에서 제기한 요양보호사 업무에 대한 인지정도 및 서비스 대상자 특성에 영향력을 갖는지에 대한 연구결과를 제시하였다.

• 지역사회간호학회지
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• 제7권2호
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• pp.183-202
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• 1996

This study was designed out to develop a home health care service for nurses working in community care services. This study investigates actual conditions at welfare institutions related to health needs the demands of clients, and the state of home health care services we hope that this study will improve upon the current service system. In Korea home health care services are still developing and only new becoming a part of the health care supply system. The data was collected by recording the client home nursing assessments modified to the situation of UTMB home health agency. In this study 107 clients were selected for home care who needed care for physical and mental deficits. The study lasted from March to November of 1995 at one of the welfare service institutions in Chunchon city. The results show that those who most frequently needed care services were over 50 years old with a health deficit of 80.3%, followed by sex as women who needed care at 59.8%. 50.5% of the clients had very little education. 99.1% of the clients live with their family, and a medical diagnostic analysis reveals that 73.9% of the 5 year period of illnesses were the following : 38.8% - muscular -skeleton system disorder, 24.4% - hypertension and stroke, 25.7% sole disease of arthritis. For behavioral conditions 43.3% of the patients were without care services, 56.6% of the patients were taking treatment that 73.5% of those were taking medication. The most main complaint of patients were 22.4% of pain in the extremities, next were 16.8% of a limitation of body activities, 15.0% was lumbo-sacralgia. According to the investigator who was a senior student nurse, the following suggestions were made: 32.7% for curative medical services, 29.9% for physical exercise, 19.6% for emotional support. Consultation nursing services consisted of 67.2% for physical therapy, 11.2% for the maintaining healing, 9.4% for counseling. The patients at home, required assistance most frequently for muscular-skeleton problems under the category of physical systems (33.3%). But, on the other hand, 49.5% of the patients required care givers at home, 28.2% had a knowledge deficit, 21.0% had malnutrition, 18.4% had bad impaired communication. The character of health problems were devided into chronic disease(67.0%), accidents(I3.1%), and general disease(15.9%). 86% of the disabled client had an impairment of the physical system. Eating (86.9%) , Toileting(77.6%), and personal care showed much the same of ADL condition, the level and range of achievement of mobility, the most frequently self performed was 81.3% only in a room size area, and 40.2% were completely dependent when going out. Although there were a large number of home care services in th community at these welfare institutions, many clients needed a variety of curative services. As policy changes have gathered momentum, responsibility for the development of a more suitable program was demanded by the clients from the community.

• 보건행정학회지
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• 제34권2호
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• pp.163-177
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• 2024

연구배경: 본 연구는 부당청구 예방형 자율점검제 시범사업의 "개선요청 통보 및 모니터링" 중재활동이 의료기관의 중재 실시 전과 후 청구건수와 청구총진료비 청구행태에 있어서의 변화를 검증하고자 하였다. 방법: 자료는 건강보험심사평가원의 2021년 7월부터 2022년 2월까지 시범사업 항목인 '정맥 내 일시주사(KK020)'를 청구한 기관 중 예방형 자율점검제 대상기관으로 선정된 1,129개 의료기관의 청구자료와 신고 현황자료를 활용하였다. 비교 대상을 선정하기 위해 1:3 비율로 성향점수매칭을 사용하였고, 청구행태 변화를 검증하기 위해 대응표본 t-검정과 t-검정을 실시하였다. 또한 청구행태 변화에 차이가 있는 경우 이에 영향을 미치는 요인분석을 위하여 회귀분석을 시행하였다. 결과: 중재 실시 전과 후의 청구행태는 실험군의 모든 의료기관 종별에서 청구건수와 청구총진료비가 유의하게 감소하였고, 의원의 대조군에서는 유의한 증가를 보였다. 의료기관 및 의사 특성에 따른 중재 실시 전·후 청구행태는 실험군은 의원의 의사 연령 40세 미만을 제외하고 모든 종별에서 유의하게 감소하였다. 대조군은 종합병원과 병원은 개원기간에서, 의원은 표시과목에서 일부 유의한 감소가 있었고, 의사 50세 이상 남성에서 유의하게 증가한 것으로 나타났다. 실험군 대상 의료기관의 청구행태에 변화에 대한 회귀분석 결과, 모든 종별에서 중재 실시 전과 후에 청구건수와 청구총진료비가 유의하게 감소하였다. 또한 의료기관과 의사 특성에서 병원은 개원기간이 길수록 유의한 증가를 나타났고, 의원은 소재지역과 표시과목(기타)에서 유의한 감소를 보였다. 결론: 실험군의 부당청구 예방형 자율점검제의 중재 실시 이후 청구경향의 변화가 연구가설대로 감소하는 경향을 보였다. 이는 제도 시행 직후에 의료기관 스스로 청구행태를 개선하고, 교정하는 사전예방적 활동의 효과가 존재하는 것으로 나타났다. 또한 대조군에서도 통보 대상기관 위주의 제도운영방식에도 불구하고 일부 유의한 감소가 나타난 것은 예방형 자율점검제의 간접적인 효과로 볼 수 있다. 따라서 비대상기관에도 청구행태 개선활동이 이루어질 수 있도록 적극적인 홍보와 교육, 간담회 등의 추가적인 지원과 지속적인 모니터링이 필요하다. 이를 통해 부당청구가 감소될 수 있도록 예방형 자율점검제를 확대하는 것이 바람직하다.

• 사회복지연구
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• 제48권4호
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• pp.121-156
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• 2017

본 연구의 목적은 회복을 어렵게 만드는 단도박자의 생활고 극복과정을 탐구하는 것이다. 연구의 목적 달성을 위해 단도박 후 생활고를 극복한 총 10명의 연구참여자들과 1:1 심층면담을 수행했다. 면담을 통해 수집한 자료는 Strauss와 Corbin(1990; 1998)이 제안한 근거이론(grounded theory) 절차에 따라 분석했다. 분석 결과 131개의 개념을 구성했으며, 구성된 개념을 다시 32개의 하위범주와 14개의 범주로 분류하였다. 연구자들은 각 범주를 관통하는 핵심범주를 '현실 수용과 재결단을 통한 생활고 극복'으로 제시했다. 연구결과를 바탕으로 연구자들은 경제적 자활 프로그램 제공, 사회보장 서비스 제공, 상담사-가족-동료 단도박자가 공조할 수 있는 '삼각 지지체계'구축 등을 실천 및 정책적 개입 방안들로 제안했다.

• 가정과삶의질연구
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• 제29권6호
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• pp.153-167
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• 2011

This study analyzed changes in postpartum depression in mothers from one month after childbirth to the first year using panel data collected overtime, in an effort to determine the relationship between the amount of change and child-rearing system variables. The subjects were 1097 mothers who belonged to both the lower and upper $30^{th}$ percentile groups in the depression change distribution of the 2008 Korean Children Panel Study (PSKC), a large, population-based study conducted by the Korea Institute of Childcare and Education. The data were analyzed by t-tests, $x^2$ tests, partial correlation coefficient analyses and regression analyses. The results are summarized as follows: First, the mothers' postpartum depression showed a significant increase during the first year as opposed to the first month after birth. Second, after controlling for socio-demographical variables of the mothers, the changes related to depression showed a positive relationship with child-rearing stress, and the child's emotional temperament, but showed a negative relationship with the mother's self-esteem, the child's birth order, and the father's participation in child-rearing activities. Third, variables having a significant effect on changes in postpartum depression were the mother's self-esteem and child-rearing stress, the child's age in months, and social support. Variables pertaining to the mother's characteristics variables had a more powerful effect than other child-rearing system variable categories. The results suggest the necessity to develop a parental education program or a mother-child health service in consideration of the variables that affect mothers, as determined in this study, in an effort to prevent postpartum depression.

• 대한지역사회영양학회지
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• 제14권6호
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• pp.846-860
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• 2009

We investigated the foodservice management practices in various operation types of childcare centers in Asan, Chungnam Province, with the intention of improving the quality of foodservice and providing the basic information for establishing more effective and efficient foodservice model system. Self-completed questionnaires were collected from the directors of 174 child care centers. The statistical analysis was completed using SPSS Ver. 12.0 program. The followings are about the results of this study. Approximately 94.8% of the directors were women with the average age of 40.3. All of the investigated facilities executed foodservice; the facilities of 96.2% had been self-operated, 1.9% was contract-managed and the remaining 1.9% served delivered meal from outside. Only 20.0% of the investigated centers employed a dietitian. In most of the centers, meals were prepared in a conventional manner and approximately 85.3% of the centers are serving only snacks twice a day as a supplementary due to financial difficulties. Menu planner of the facilities, which have no dietitian was the director (35.8%) or the cook (25.7%). In most centers, the directors purchased the food materials (67.5%). Material inspection was done by the director (54.9%) or the cook (40.5%). However, home care centers did not inspect the food material. These results indicate that food service management guidelines need to be established by the facility type with the government control and financial support. Especially, dietitian employment and the efficient foodservice model system establishment are questions that confront us.