• Title/Summary/Keyword: 기관명

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Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.555-577
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    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

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강원지역 보건진료원에 관한 업무 분석 연구

  • Jo, Won-Jeong;Lee, Gyeong-Ja
    • Research in Community and Public Health Nursing
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    • v.1 no.1
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    • pp.172-173
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    • 1989
  • 본 연구는 전국의 보건진료원이 하는 업무를 분석하여 우리나라 보건진료원 제도 정착에 도움을 주는 기초자료를 제공하는 연구의 일환으로 강원도 지역에서 실시하였다. 연구대상은 강원도에 있는 보건진료원 전수로 하였고 이중 응답자수는 108명이었다. 연구도구는 문헌과 간호교육자들에 의해 작성 된 구조화된 설문지를 사용하였으며 수집된 자료는 SPSS를 이용하여 빈도, 백분율, 평균 및 피어슨 상관계수를 구하였고 유의성 검정을 위해서 t-test, ANOVA의 통계방법을 사용하였다. 본 연구결과를 통하여 얻은 결론은 다음과 같다. 1) 조사대상자인 보건진료원의 평균 연령이 31.5세이며 과반수의 보건진료원이 30세 미만 이었고 기혼자가 마혼자보다 약간 많았다. 보건진료원의 반수 이상이 현재 가족과 동거하고 있었고 학력은 3년제 간호전문대학 졸업자가, 경력은 3년 미만인 사람이 대부분이었으며 종교를 가진 사람이 대부분 이었으며 종교를 가진 사람이 안가진 사람보다 더 많았다. 또한 보건진료원의 근무지역 조건은 대부분이 을지에서 근무하고 있었고 대부분의 보건진료원이 신축된 보건진료소 시설에서 업무를 수행하고 보건진료소 내의 숙소에서 거주하는 것으로 냐타났다. 2) 보건진료원이 담당하는 평균 주민수는 1,660.8명 이었으며 과반수 정도의 보건진료원이 $501\sim1,000$명이 이상적인 적정 담당 주민수라고 생각하고 있었다. 강원도 주민의 연평균 보건진료소 이용자수는 4,099.3명 이었고 이용 주민수가 5,000명 이상인 보건진료소도 11개소 12.9 %나 되었다. 3) 보건진료소 사업대상지역 내에 있는 보건 의료기관은 약방 및 약종상이 62.1 %로 가장 많이 분포되어 있었고 보건지소도 16 %나 사업대상지역 내에 함께 있는 것으로 나타났다. 지역주민의 보건의료기관 이용은 보건진료소가 59.0 % 로 지역주민이 가장 많이 이용하고 있었고 보건 진료원이 가장 많이 이용하는 의뢰기관은 뱅 의원이 66 %, 보건소가 36.4 %로 나타났다. 또한 보건진료소의 보건의료기관과의 협조관계는 보건소와는 과반수 정도가 잘 협조하고 있다고 응답 한 반면 보건지소와 잘 협조하고 있다고 응답한 율은 37.6 % 밖에 안되었다. 4) 보건진료원이 업무영역 수행 정도를 살펴 보면 5점 만점에 통상질환관리가 3.69점, 사업 운영 관리 및 지도는 3.45점, 모자보건 및 가족계획은 3.28 점, 지역사회 조직 및 개발은 3.27 점, 보건정보체계 개발 및 수집은 3.17 점, 사업 계획 수립은 3.14 점, 지역사회 보건관리는 3.13 점의 순으로 나타났다. 보건진료원의 업무영역을 l 일 8 시간으로 하여 l 주 44 시간을 기준으로 측정하면 통상질환관리 18.56시간, 지역사회 보건관리 5.67 시간, 모자보건 및 가족계획 5.52 시간, 사업 운영관리 및 지도 4.10시간, 지역사회 조직 및 개발 3.05 시간, 보건정보체계 개발 및 수집 2.94 시간, 사업계획 수립 2.89시간의 순으로 나타났다. 5) 보건진료원의 업무영역별 수행 소요시간의 상판판계를 살펴보면 지역사펴 조직 및 개발을 위 해 소요한 시간은 사엽계획 수립 소요시간 및 보건정 보체계 관리 소요시간과 순상관관계를, 사업 계획 수립 소요시간은 지역사회 보건관리, 모자보건 및 가족계획 관리 소요시간 및 보건정보체제 관리 소요시간과 순상관관계를 나타냈다. 또한 통상질환관리 소요시간은 지역 사회 조직 및 개발, 사업계획 수립, 지역사회 보건관리와 모자보건 및 가족계획 관리, 사업운영 관리 및 지도, 보건정보체계 관리 소요시간과 역상관관계를 나타내었다. 6) 보건진료원의 총 업무수행 정도를 잘펴보면 업무수행 점수의 평균은 87.5점이었으며 보건진료원의 근무지가 병지이고 보건진료소의 시설상태가 나쁜 경우 업무수행 점수가 높은 것으로 나타났으며 업무수행 정도와는 별 차이가 없었다.

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Bronchoscopic Diagnosis in ICU Patient Accompanying Pneumonia (폐렴이 동반된 중환자실 환자에 대한 기관지내시경적 진단)

  • Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.114-123
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    • 1997
  • Background : To assess the diagnostic role of bronchoscopic lavage for the evaluation of pneumonia in intensive care unit(ICU), the results were compared to blind endobronchial specimen. Method : From September 1993 to August 1996, twenty-eight ICU patients suspected pneumonia on the basis of clinical evidence and performed bronchoscopy under the diagnostic or therapeutic purpose were studied retrospectively for the clinical findings including culture of bronchoscopic and blind endobronchial specimen. Bronchoscopic specimen was got through small amount of bronchoalveolar lavage with 20-40ml saline, one or two times on the suspected site. Results : l. Main reasons of ICU admission were respiratory and impending respiratory failure Nosocomial pneumonia was most common with 16 cases; each for community acquired and immunocompromised type with 6 cases. Diagnostic purpose of bronchoscopy was performed in 20 cases as 71 percent in total, whereas therapeutic removal of secretion in 8 cases. The complication during bronchoscopic evaluation was trivial. 2. The agreement between blind endobronchial and bronchoscopic specimen on microbial culture was only 39.3 percent. However, 2 cases each for aspergillosis and tuberculosis were diagnosed under bronchoscopic evaluation. 3 The application of mechanical ventilation occured significantly frequently in multidrug resistant pneumonia compared with other pneumonia in terms of bronchoscopic specimen. 4. The application of mechanical ventilation was significantly common in nosocomial pneurmonia compared with other types of pneumonia. Conclusion : The selective bronchoalveolar lavage and therapeutic removal of bronchial secretion with bronchoscopy in ICU patient accompanying pneumonia is a very useful tool with safety. The multidrug resistant pneumonia or nosocomial pneumonia could be closely associated with the use of mechanical ventilation.

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The Status of Home-Based Hospice Care in Korea (국내 가정 호스피스 운영 실태)

  • Park, Chai-Soon;Yoon, Soojin;Jung, Yun
    • Journal of Hospice and Palliative Care
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    • v.16 no.2
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    • pp.98-107
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    • 2013
  • Purpose: This study was conducted to investigate how home-based hospice care is provided in Korea. Methods: From July 2011 through August 2011, 29 hospice facilities that provide home-based hospice care were surveyed using a questionnaire. Items included in the questionnaire were general characteristics of the organization, staff members, service programs, difficulties. Results: Among the surveyed, hospice care was hospital-based for 11 (37.9%) facilities, hospital-independent center-based care for four (13.8%) and home-based care only for 10 (34.5%). Near half the participants were located in Seoul and Gyeonggi-do. Caregivers included nurses for 62.1% of the participants, volunteers 62.0%, pastors 44.8%, social workers 37.9%, coordinators 31.0% and doctors 31.0%. The facilities offered service programs such as family counseling (96.6%), transfer to other facilities (93.1%), psychological support (89.7%), bereavement support (86.2%), dying care (79.3%), clinical care (75.9%) and spiritual support (75.9%). The major obstacles were financial issues (24.1%), lack of trained staff (20.7%) and staff members' lack of awareness of home-based hospice care (13.8%). Conclusion: In Korea, home-based hospice care is provided by an insufficient number of facilities. Moreover, the service providers are experiencing difficulties such as lack of trained staff, insufficient financial resource and staff's lack of awareness of home-based hospice care. It is necessary to increase the number of home-based hospice care facilities with consideration of even distribution across regions and standard staffing and service programs and develop related insurance policies.

A Study on the Improvement of Research Records Appraisal Practice of the Government-funded Research Institutions (정부출연연구기관의 연구기록 평가 개선방안 연구)

  • Ahn, Chaeyoung;Kim, Jihyun
    • The Korean Journal of Archival Studies
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    • no.66
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    • pp.105-155
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    • 2020
  • Research records are a type of record with a range of controversies over the core elements of management, such as the definition and scope of research records, and who manages research records, despite the critical need for their management. Research records have been neglected in blind spots because it is difficult to manage them, but if well managed, they are evaluated as records with a highly potential value that can be used infinitely later. In particular, government-funded research institutes, as both research institutes and public institutions, take responsibility for systematic management of these research records. Therefore, as this study noted the necessity of research records appraisal for the systematic management of research records in government-funded research institutes, and conducted interviews with 11 records managers working at government-funded research institutes in Korea, the current status of research records management and appraisal of government-funded research institutes was identified. As a result, improvement measures for research records appraisal was suggested as follows. First of all, in the light of the current public records appraisal system, there is a problem of effectiveness in applying it to the research record appraisal system as it is. Therefore, this study suggested that an appraisal system appropriate for research records was needed, and proposed plans for improving the research records appraisal system in terms of purposes, authority, methods, time point, tools and criteria for appraisal.

Influence of Recognition for Health Care Accreditation on Patient Safety Managing Activities of Nursing Staffs in Geriatric Hospital (의료기관 인증제에 대한 인식이 요양병원 간호인력의 환자안전관리 활동에 미치는 영향)

  • Kweon, Myeung Sook;Jo, Hyun Sook
    • 한국노년학
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    • v.38 no.1
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    • pp.15-26
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    • 2018
  • This study was aimed to investigate the influencing level of nursing staff's recognition for the health care accreditation on patient safety managing activities by identifying the relationship between them and other factors affecting on patient safety managing activities. Subjects of this study were 182 nursing staffs working in six geriatric hospitals accredited for health care in Seoul metropolitan area. Data was collected during April, 2016 by structured questionnaires. And SPSS/WIN 15.0 program with t-test, ANOVA, Pearson's correlation, and stepwise multiple regression analysis were employed for analyzing them. 96.2% of the subjects have recognized the accreditation and 31.8% of them have acknowledge it in detail. The average level of recognition for the health care accreditation and patient safety managing activity were 3.60 and 4.39 point (max.5.0) respectively. Correlation between them was positive(r=.339, p<.001). Significant factors influencing patient safety managing activity were internal service quality promotion (t=5.292, p<.001) and academic background (t=2.836, p=.005). Education program or information on health care accreditation system, and action plans for promoting internal service quality for the nursing staffs including job standardization of the jobs are recommended for the better patient safety managing activities.

A Study on Awareness Levels of Personal Information Protection in Health Care Workers (개인정보 보호에 대한 의료기관 종사자들의 인식수준에 관한 연구)

  • Hong, Ju-Youn;Kim, Hwan-Hui
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.8
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    • pp.647-659
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    • 2019
  • The purpose of this study was to examine the relationship between the awareness of health care workers on the protection of patient health information and their practice of it in an attempt to provide some information on the policy setting of health care institutions about medical information protection. As a result, the awareness of the health care workers on the protection of patient health information and their practice of it were both the best in the communication area, followed by the patient health information management area and the area of direct contact with health information. As for the variables linked to their awareness and practice of patient health information protection, the type of the health care institutions, job satisfaction, religion and the departments in which they worked were significantly related. To determine what factors affected the patient health information management area, a multiple regression analysis was carried out by selecting the area of direct contact with patient health information and the communication area as independent variables and by selecting the patient health information management area as a dependent variable. And it's found that the patient health information management area became better when the area of direct contact with the information and the communication area were better.

An Investigation on Employment Effect of Senior Job Training (준·고령자 직업훈련의 훈련생 및 훈련 특성이 재고용에 미치는 효과)

  • Lee, Kyung Hee;Lee, Yohaeng
    • 한국노년학
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    • v.31 no.3
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    • pp.527-538
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    • 2011
  • The purpose of this investigation is to analyze the effect of employment and quality of employment of senior job training. The questionnaire administered to 576 senior job trainees(over 50 years old) and 28 training institute before and after job training to survey job training characteristics, training institute characteristics and trainee characteristics. The results were as follows : First, independence test(X2) revealed that occupational category, period of training, type of institution, training history, location, and trainee's education level had significant difference on employment. Second, The probability of employment was higher in new and well-equipped public institution than private or old public institution. Third, compared with the prior wage, the wage after training decreased. This result suggested that the unemployed senior can hardly be reemployed in prior level job. The result of analysis on the cases of increased wage after training revealed that the trainees who was women, had a little dependent family, a shorter unemployed period, and a higher prior wage showed higher wage than prior wage after training.

Study on the Experience of Unbelief in the Process of Providing Home Visiting Care Service: Focusing on the perspective of the Facility Director (재가방문요양 서비스 제공과정에서 겪는 불신경험에 관한 연구: 시설운영자 관점을 중심으로)

  • Jun-Suk Kim;Ji-Hye Kim;Jung-Mi Kim;Mi-Young Park;Byung Woo Lim
    • Journal of Industrial Convergence
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    • v.21 no.10
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    • pp.65-80
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    • 2023
  • Through inductive content analysis, this study sought to examine the crisis experienced by the institution, the quality of service, and the distrust of the system and institution based on the experience of distrust in the home-visiting care service of bbeneficiary and guardians. FGI was conducted on five managers of institutions that provide home-visiting care services. As a result, the central phenomenon was found: deterioration of service quality, distrust of systems and institutions, and difficulties in opera-ting long-term care institutions. In order to improve the quality of home-visited care services and build trust in care workers and institutions, first, home-based associations or operating corporations should develop new education program plans and manuals to strengthen the capabilities of care workers and social workers. Second, the NHIS's monitoring system and the professional management system of care workers should be established. Third, it is necessary to improve awareness of the role, expertise, and rights of care workers, and fourth, improvement measures are required to reduce the turnover rate of care workers, which is the cause of the deterioration of the quality of long-term care services.

Airway Compression or Airway Anomaly Causing Respiratory Symptoms in Infants and Children with Cardiovascular Diseases (심혈관계 질환 환아에서 동반된 기도 압박 및 기도 기형의 임상적 특성)

  • Kim, Ja-Hyeong;Lee, So-Yeon;Kim, Hyo-Bin;Koo, So-Eun;Park, Sung-Jong;Kim, Young-Hui;Park, In-Suk;Ko, Jae-Gon;Seo, Dong-Man;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.737-744
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    • 2005
  • Purpose : Infants and children with cardiovascular diseases often present with respiratory symptoms. However, missed or delayed evaluation for potential airway problem may complicate overall prognosis. The aim of this study is to determine the clinical characteristics of these patients and explore the cause of airway problem. Methods : We reviewed the medical records of 64 patients(M : F=33:31, mean age : $6.3{\pm}7.5$ months) whose airway problems were proven by computed tomography or bronchoscopy in perioperative periods at the Asan Medical Center from January 1997 to June 2004. Patients were divided into two groups based on the duration of ventilator care : ${\leq}7$ days(group 1 : 23 cases, M : F=10 : 13) and >7 days(group 2 : 41 cases, M : F=23 : 18). Results : The patients in group 2 significantly developed more post-operative respiratory symptoms than group 1(P<0.001) and had more airway problems including extrinsic obstruction, intrinsic anomaly, and combined problem than group 1 although not significantly different(P=0.082). Among underlying diseases, the most common diseases were vascular anomaly(26.2 percent) and aortic arch anomaly(26.2 percent) in group 1 and pulmonary atresia with ventricular septal defect(22.4 percent) in group 2. The most frequent respiratory symptoms were recurrent wheezing pre-operatively and failure of ventilator weaning post-operatively. The major types of airway anomaly were tracheomalacia and tracheal stenosis(in each case 18.2 percent). Nineteen patients with persistent airway problems underwent aortopexy or other vascular correction. Of the 19 patients, 13(68.4 percent) were improved, but 2 failed in weaning ventilator and 4 died of non-airway problems. Conclusion : Early evaluation and treatment for potential airway problems may affect natural or surgical prognosis in patients with cardiovascular diseases presenting with respiratory symptoms.