• Title, Summary, Keyword: Activity Limitation

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The Prevalence and Association Factors of Unmet Medical Needs by Age Group in the Elderly (노년기에 따른 미충족 의료 현황 및 관련 요인)

  • Hwang, Byung-Deog;Choi, Ryoung
    • The Korean Journal of Health Service Management
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    • v.9 no.1
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    • pp.81-93
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    • 2015
  • This study investigated the prevalence of unmet needs for health care among Korean adults and related factors. Using data from the 2012 Korea Health Panel, 1,896 adults aged 65 and over and two age groups(Young-Old(66-74) and Old-Old($65{\leq}$)) were analyzed to identify these factors. Logistic regression analysis was used to examine the main factors associated with unmet medical needs. According to the results of this study, the factors influencing unmet medical needs with regard to economic factors were Subjective Health Status(young-old), Disability(young-old), Activity Limitation(young-old), Education Level(old) and Economic Activity(old). The factors influencing unmet medical needs were factors of attitude, information, and disease. factors were Disability(young-old), Activity Limitation(young-old), Education Level(old) and Economic Activity(old). Therefore, further research that investigates unmet needs depending on age group in the elderly would suggest helpful policy implications.

Development of the Model for Activity Based Costing in the Hospital (의료기관의 활동기준원가 산출 모형)

  • Chun, Ki-Hong;Cho, Woo-Hyun;Kim, Bo-Kyung;Kim, Byung-Cho
    • Korea Journal of Hospital Management
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    • v.6 no.2
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    • pp.37-69
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    • 2001
  • A new cost management system, called Activity Based Costing (ABC) system, has arisen to solve the limitation of a Traditional Cost Accounting (TCA) system until last two decades and ABC has been applied by many companies. TCA systems have limitation in tracing cost because they arbitrarily allocate overhead cost to the cost objects without standard for direct cost distribution. ABC is an accounting system that assigns costs to products or services based on the resources they consume. The costs of all activities are traced to the products for which they are performed. Therefore ABC is a cost management system that provides a matrix to accurately quantify consumed resources triggered by activities and activities triggered by products and services. There is little implementation of ABC in the health services field, one of service industries, due to complicated and many activities, and volatile cost object. However, the necessity for applying reasonable cost accounting system is largely issuing as strategy responding hostile environment, and financial pressure, and it is imperative to implement the Activity Based Costing (ABC) system. Therefore, this study presents the framework to develop ABC system for total health service organizations. Cost objects in this study base on medical service activities per health insurance claim from one general hospital located in Metropolitan Statistical Areas (MSAs). Medical service activities include all health insurance claims in the hospital. The purpose of the study is presenting useful tools and basic frame to develop Activity Based Costing system for health service organizations which want to use ABC system. The steps to develop ABC system for health service organizations are following: 1. Identifying of activity centers; 2. Definition of cost objects and activity by activity center; 3. Analysis of activity and tracing activity contribution; 4. Allocation of direct cost for specific activity; 5. Allocation of indirect cost for specific activity; 6. Allocation of depreciation for facilities, applicants, and consumption goods; 7. Allocation of administration cost; 8. Allocation of cost among activity centers; and 9. Tracing cost of cost objects by activity center. This study identified necessary information from existing reports which hospitals generally made by each step, and defined outcome which had to be produced in each step using this information. The steps of this study had limitation to apply all different size hospitals because the steps were structured ABC system by one hospital, however, this study used similar basic framework and methods with general cases. When a health service organization want to apply Activity Based Costing (ABC) system on all activities of it in future days, this study is very useful to design system structure in the health service organization.

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A Study on the Relationship between Activity of Daily Living and Job Status of the Disabled from the Functional Limitation Perspectives (기능제한(Functional Limitation) 관점에서 본 뇌성마비인의 일상생활수행능력과 취업여부의 관계에 대한 연구)

  • Kim, Jung-Woo;Kim, Bong-Sun
    • Korean Journal of Social Welfare
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    • v.59 no.1
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    • pp.223-249
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    • 2007
  • This study is intended to investigate if the standard of vocational rehabilitation service could be solely determined by medical standard for disability definement and to find out what alternatives are available to resolve practical problems for those who are not identified as the severely disabled by the disability definement but do experience severe handicaps at work. Through the literature review, the researcher argued that the concept of 'functional limitation' would be a criteria, and thereby applied Modified Barthel Index to measure the degree of functional limitation. In view of researching the relationship among physical impairment, functional limitation, and job status based on 381 cerebral palsied, variables such as the type of cerebral palsy and the part of paralysis, have neither direct nor indirect influence to the job status; however, the pain and the mobility have indirect effects, and the ability of self-management has direct effect on the job status. The researcher concluded that future research about disabilities needs to provide a serious thought on what it is to be defined as 'disabilities', as well as to focus on further research conceptualizing the degree of physical 'functional limitation'.

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Applying ICF model into practice in PNF (ICF 모형의 고유수용성신경근촉진법 실기 적용)

  • Lee, Moon-kyu;Kim, Tae-yoon
    • PNF and Movement
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    • v.7 no.1
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    • pp.17-23
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    • 2009
  • Purpose : To provide a convenient framework for PNF practice, we reviewed the relationship between ICF framework and PNF framework. Methods : We reviewed literatures related with ICF and PNF. Results : ICF model is useful tool for physical therapist who is working in PNF to identify the interactions the components of individual's health, especially the relationship between functioning and disability. A framework for PNF is philosophy which included the concept, functional approach. It is essential to identify primary activity limitation and causal impairment in PNF field and evaluate the their relationship. The ICF model can be used to classify the examination information. Next step is to prioritize the activity limitation and then evaluate the interrelationships among each components of the ICF framework. Conclusions : ICF model guides physical therapist in PNF practice to identify patient problems and evaluate the interrelationship of components of their health. This model is logical framework to directs functional approach as PNF philosophy to be approached the goal.

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A Study on Assessment of Patient with Lumbar Spinal Stenosis (요추 척추관 협착증의 평가척도에 대한 고찰)

  • Park, Kyoung-Su;Chung, Seok-Hee
    • The Journal of Korea CHUNA Manual Medicine for Spine and Nerves
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    • v.2 no.1
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    • pp.23-38
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    • 2007
  • Objectives : The aim of this study was to understand scale of lumbar spinal stenosis. Methods : Papers including questionnaires for assessment disability, fuction, activity limitation, or prticipation restriction in adult patients with low back pain or spinal stenosis were searched in the MEDLINE. Results and Conclusions : 1. VAS, VRS, NRS were recommended to the pain scale. 2.ODI and RMDQ were recommended to the function scale. 3. ODI, RMDQ, QBPDS, LBOS, MVAS, WDI commonly used to the fuction scale.

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Prevalence and Its Influencing Factors on Depression among Elderly Vulnerable People in Urban Community (일 도시지역 취약노인의 우울 유병률과 영향 요인)

  • Kim, Hye-Ryoung
    • The Korean Journal of Health Service Management
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    • v.7 no.3
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    • pp.275-286
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    • 2013
  • To identify the prevalence and its influencing factors on depression among elderly vulnerable people in one urban community. This study used data from 381 of elderly vulnerable people in the community. The prevalence of depression was found to be 51.97%. Multivariate logistic regression analysis shows that depression was more prevalent as people in female gender; people with lower self-esteem compared to those with higher self-esteem; in elderly who perceived lower social support compared to those who perceived higher social support; and in the older adults with limitation in instrumental activity of daily living. The finding of a significant association between gender difference; self-esteem; perceived social support, and limitation in instrumental activity of daily living and occurrence of depression expected to promote the screening strategy for elderly at risk of depression in Korean community.

Influencing Factors on Health-related Quality of Life in Middle and Old Adult One-Person Households (중노년 1인가구의 건강관련 삶의 질 영향요인)

  • Kwon, Jong Sun
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.1
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    • pp.153-167
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    • 2019
  • Purpose: The aim of this study was to examine factors influencing health-related quality of life in middle and old adult one-person households. Method: This study carried out secondary analysis using the data from the $7^{th}$ Korean National Health and Nutrition Examination Survey. Subject samples who were selected are 497 middle and old adult one-person households over 40 years. Data were analyzed using descriptive statistics, simple and multiple regression techniques with the SPSS/WIN 24 program. Result: Factors influencing health-related quality of life in middle adult one-person households were activity limitation, depression, exercise, smoking habits with 57% prediction. In male old adult one-person households they were subjective health, metabolic syndrome, activity limitation, perceived stress with 44.8% prediction and in female old adult one-person households they were subjective health, activity limitation, home income with 35.9% prediction. Conclusion: Therefore, to improve their health-related quality of life it needs to develop & to apply national and local promotion policy and intervention program on health-related quality of life of middle and old adult one-person households.

A study on evaluation of the image with washed-out artifact after applying scatter limitation correction algorithm in PET/CT exam (PET/CT 검사에서 냉소 인공물 발생 시 산란 제한 보정 알고리즘 적용에 따른 영상 평가)

  • Ko, Hyun-Soo;Ryu, Jae-kwang
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.55-66
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    • 2018
  • Purpose In PET/CT exam, washed-out artifact could occur due to severe motion of the patient and high specific activity, it results in lowering not only qualitative reading but also quantitative analysis. Scatter limitation correction by GE is an algorism to correct washed-out artifact and recover the images in PET scan. The purpose of this study is to measure the threshold of specific activity which can recovers to original uptake values on the image shown with washed-out artifact from phantom experiment and to compare the quantitative analysis of the clinical patient's data before and after correction. Materials and Methods PET and CT images were acquired in having no misalignment(D0) and in 1, 2, 3, 4 cm distance of misalignment(D1, D2, D3, D4) respectively, with 20 steps of each specific activity from 20 to 20,000 kBq/ml on $^{68}Ge$ cylinder phantom. Also, we measured the distance of misalignment of foley catheter line between CT and PET images, the specific activity which makes washed-out artifact, $SUV_{mean}$ of muscle in artifact slice and $SUV_{max}$ of lesion in artifact slice and $SUV_{max}$ of the other lesion out of artifact slice before and after correction respectively from 34 patients who underwent $^{18}F-FDG$ Fusion Whole Body PET/CT exam. SPSS 21 was used to analyze the difference in the SUV between before and after scatter limitation correction by paired t-test. Results In phantom experiment, $SUV_{mean}$ of $^{68}Ge$ cylinder decreased as specific activity of $^{18}F$ increased. $SUV_{mean}$ more and more decreased as the distance of misalignment between CT and PET more increased. On the other hand, the effect of correction increased as the distance more increased. From phantom experiments, there was no washed-out artifact below 50 kBq/ml and $SUV_{mean}$ was same from origin. On D0 and D1, $SUV_{mean}$ recovered to origin(0.95) below 120 kBq/ml when applying scatter limitation correction. On D2 and D3, $SUV_{mean}$ recovered to origin below 100 kBq/ml. On D4, $SUV_{mean}$ recovered to origin below 80 kBq/ml. From 34 clinical patient's data, the average distance of misalignment was 2.02 cm and the average specific activity which makes washed-out artifact was 490.15 kBq/ml. The average $SUV_{mean}$ of muscles and the average $SUV_{max}$ of lesions in artifact slice before and after the correction show a significant difference according to a paired t-test respectively(t=-13.805, p=0.000)(t=-2.851, p=0.012), but the average $SUV_{max}$ of lesions out of artifact slice show a no significant difference (t=-1.173, p=0.250). Conclusion Scatter limitation correction algorism by GE PET/CT scanner helps to correct washed-out artifact from motion of a patient or high specific activity and to recover the PET images. When we read the image occurred with washed-out artifact by measuring the distance of misalignment between CT and PET image, specific activity after applying scatter limitation algorism, we can analyze the images more accurately without repeating scan.

Trend of Influencing Factors on Health-related Quality of Life in Korean Elderly (한국 노인의 건강관련 삶의 질과 영향요인 추이)

  • An, Jisook;Choi, Hye Young
    • Journal of Korean Public Health Nursing
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    • v.32 no.2
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    • pp.275-287
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    • 2018
  • Purpose: This study examined the trends of socio-demographic and health factors affecting the health-related quality of life (HRQoL) in Korean elderly. Methods: Data were obtained from the Fourth, Fifth and Sixth Korean National Health and Nutrition Examination Survey (KNHANES V-1, 2007, KNHANES V-1, 2010, KNHANES V-2, 2014). The sample consisted of 3,668 Korean individuals aged 65 years and older. The data were analyzed using a t-test, Chi-square test and multiple linear regression using the SPSS/WIN 20.0 program. Results: The HRQoL is improving consistently and the affecting factors on the HRQoL were the education level, activity limitation, subjective health and walking days per week in the three data of 2007, 2010, and 2014. Conclusion: A health care program focusing on improving activity limitation and physical activity should be considered for the improvement of HRQoL for the elderly in the community.

Factors Influencing Insufficient Physical Activity in Community-dwelling Elderly Individuals with Dementia: Using a 2014 Survey of Living Conditions of Elderly Individuals (지역사회 거주 치매 노인의 신체활동 부족 영향요인 : 2014 노인실태조사 활용)

  • Kang, Hyun-Wook
    • The Korean Journal of Health Service Management
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    • v.12 no.1
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    • pp.109-121
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    • 2018
  • Objectives : This study aimed to identify the factors influencing insufficient physical activity in community-dwelling elderly individuals with dementia. Methods : Data were analyzed using a 2014 Survey of Living Conditions of Elderly Individuals. Metabolic Equivalent Task (MET) hours were calculated using self-reported weekly frequency, duration, and types of physical activities to measure the degree of physical activity. Results : Mean MET hours were $4.03{\pm}8.59$. Factors influencing insufficient physical activity included limitations in activities of daily living (ADL), lower frequency of social group participation and unsatisfactory relationships with friends or community. When demographic factors were adjusted, patients with ADL limitation had 11.2 times higher risks of insufficient physical activities than those without. Conclusions : Community-dwelling elderly with dementia performed low levels of physical activity. Further research is needed to develop strategies to encourage physical activity participation in this population.