• Title/Summary/Keyword: 의료비 부담

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Nursing Need and Satisfaction of Patients in Hospice Ward (호스피스병동 입원 환자의 간호요구도와 간호만족도)

  • Kim, Jung Ah;Kim, Kyunghee;Kang, Hee Sun;Kim, Ji-Su
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.248-258
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    • 2014
  • Purpose: This study was conducted to explore the nursing needs and satisfaction of patients who are hospitalized at hospice palliative care institutions. Methods: This study included 80 hospice patients who were in-patients of the hospice department of two general hospitals in S city. The collected data were analyzed by descriptive statistics, t-test, one-way ANOVA, and Pearson's correlation coefficients using the IBM SPSS 20.0 program. Results: The mean score of nursing needs and satisfaction were 3.58 (${\pm}0.31$) and 3.25 (${\pm}0.20$) respectively. Significant differences in hospice nursing needs and satisfaction were observed in terms of general characteristics including gender, education level, occupation, religion, support for medical expense and functional status. Significant positive correlation was found between the overall nursing needs and nursing satisfaction. Conclusion: Based on the results of this study, in order to improve the quality of hospice service, further study is necessary in a comprehensive manner to develop nursing intervention to meet physical, psychological/social, spiritual, and educational/referral nursing needs of hospice in-patients.

Factors Influent on Treatment Decision for the Need of Dental Implant (치과임플란트 대상환자의 치료결정에 영향을 미치는 요인)

  • Kim, Su-Gwan;Son, Soon-Yong;Jeong, Seon-A;Jeong, Mi-Ae
    • The Journal of the Korea Contents Association
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    • v.11 no.11
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    • pp.264-273
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    • 2011
  • This study subject is to provide appropriately basic information about annually increased implant treatment by their lost teeth base on increasing old people and also analyze factors influencing implant treatment decisions for patient. For about 3 month from July on the 2010, This survey was carried out at 13 dental clinic as target of 217 patients on categorized into implant treatment-group and non-treatment-group in Seoul and Gyeonggi-do. Implant treatment-group showed highest portion at 50(30.3%), non- Implant treatment-group showed highest portion at 20's(35.7%), And The patients of implant treatment-group are good oral condition, and they showed a positive attitude. Result of analysis by multiple logistic analysis(regression), Factors of influencing implant treatment decision are age, gender, period of education, monthly income, condition of periodontal tissue, regular checkup, counseling attitude, trust in hospital. Therefore, proactive management about the necessity of regular dental check-up is needed the education and promotion. And medical team should have efforts to Improving technique of medical consultations and Improving the trust of the hospital's for implant treatment decision. Also, The patient's subjective determine rather than it is important to preparing to facilitate decision of specific clinical basis. And The government's financial support and policy alternatives are certainly required in order to be implant treatment without cost burden.

A Study on the Design Preference Survey for Development of Auxiliary Therapy Products Utilizing Music of Mild Cognitive Impairment (경도인지장애인의 음악을 활용한 보조 치료기기 제품개발을 위한 디자인 선호도 조사에 관한 연구)

  • Lee, Hae Goo
    • Korea Science and Art Forum
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    • v.31
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    • pp.355-365
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    • 2017
  • The future population of Korea is expected to reach the second highest level in the world by 2060 for the elderly. It is because of the rapid development of low fertility and medical technology. The burden of society for the elderly is expected to increase steadily. The elderly person firstly appears functional disorder. They have low ability in memory and in cognitive will be. Their activities are therefore limited. And economic production capacity is sharply reduced. Self-sufficiency is a difficult situation. They need help in economic and social aspects. Products for them need research and development. The elderly have a Mild Cognitive Impairment(MCI) stage with poor cognitive abilities. It is effective to combine pharmacological and non-pharmacological treatment methods for people with mild cognitive impairment. The effects of non-pharmacological treatments on music have been proven. This paper is a study on the appearance from the viewpoint of design in the development of ancillary instruments using music therapy techniques with Digital Convergence. For this study, we investigated the preference for external appearance of mild cognitive impairment. Two times surveys were conducted. As a result, the design of home care product for the hard cognitive impaired was different from that of a conventional game machine or set top box. It should be designed according to the user's special circumstances. They are memory and cognitive abilities. Products that meet physical and mental changes must be developed.

Study on the Efficient Integration of Long-term Care Facilities and Geriatric Hospitals by Using NHIC Survey Data (실태조사를 통한 장기요양시설과 요양병원의 효율적 연계방안)

  • Choi, in-duck;Lee, eun-mi
    • 한국노년학
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    • v.30 no.3
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    • pp.855-869
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    • 2010
  • The purpose of this study is to identify how to efficiently integrate long-term care facilities into geriatric hospitals. We conducted a survey on the current operations of facilities and medical services of 2009 of 192 long-term facilities and 168 geriatric hospitals in Korea between October and November. Technical statistics and chi-square test were conducted on the collected data using the SPSS 13.0/Win program. There was a difference between the two facility types in terms of the co-payment levels of the food services. Both types selected the budget deficit as their major management problem. Ease of access and the surrounding environment were critical factors used to select the location of both types of facilities. Facility users benefited from the discounted co-payments of both facility types. However, facility users wanted more frequent visits and support from their family members during their stay at the facilities. It was discovered that users in the long-term care facilities stayed longer, that is until they died, compared to their counterparts in geriatric hospitals. The two types of facilities provided their services totally separately to users. Users of the two types of facilities are poorly supported and cared for by their families. This study suggests that setting reasonable service fees, paying caretakers, introducing an integrated facility, strengthening facility assessment standards, introducing the family doctor system, and introducing the handling of long-term care insurance by geriatric hospitals would allow the integration between long- term care facilities and geriatric hospitals to be beneficial.

Analysis of Frequent Disease and Medical Expenses Structure of Patients Admitted in a Vaterans Hospital (일개 보훈병원 입원환자의 상병 및 진료비 구조분석)

  • Kim, Kyoung-Hwan;Lee, Sok-Goo;Kim, Jeong-Yeon
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.

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Occurrence of Wilting Disease(Fusarium spp) according to Crop Rotation and Continuous Cropping of Sesame(Sesamun indicum) (참깨연작(連作) 및 윤작재배(輪作栽培)에 따른 시들음병(病)(Fusarium spp)의 발생상황(發生狀況))

  • Paik, Su-Bong;Do, Eun-Su;Yang, Jang-Seock;Han, Man-Jong
    • The Korean Journal of Mycology
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    • v.16 no.4
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    • pp.220-225
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    • 1988
  • This study was carried out to investigate the effect on the system of crop rotation of sesame(Sesamum indicum L). The results of infected plant percentage and yield of sesame wilting disease, fluctuation of density of Fusarium oxysporum and Actinomycetes, and their pathogenicity test on Fusarium spp isolated from sesame cultural soil were investigated. Density of F. oxysporum was the highest in a sesame continuous cropping soil but that of Actinomycetes was the lowest in that soil. And that of F. oxysporum and Actinomycetes according to investigation date was the highest at June. 30 and July. 30, respectively. Their pathogenicity of F. oxysporum and F. solani isolated from sesame cultural soil to sesame, peanut and green gram were recognized to all isolates except one isolate among F. oxysporum 8 isolates and one isolate to sesame, 2 isolates to peanut and all isolates to green gram among F. solani 4 isolates. F. oxysporum density and infected plant of wilting disease were increased as a result of replanted cultivation of sesame, and yield of that was prominantly reduced. Relation between density of F. oxysporum in cultural soil and infected plant percentage showed positive correlation and yield index highly negative. There was little difference between sesame-upland rice and sesame-peanut in the system of crop rotation.

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Does Home Oxygen Therapy Slow Down the Progression of Chronic Obstructive Pulmonary Diseases?

  • Han, Kyu-Tae;Kim, Sun Jung;Park, Eun-Cheol;Yoo, Ki-Bong;Kwon, Jeoung A;Kim, Tae Hyun
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.128-135
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    • 2015
  • Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

Financial Impact of Off-Pump Coronary Artery Bypass (체외순환 없이 시행하는 관상동맥우회술의 경제성 분석)

  • Lim, Cheong;Chang, Woo-Ik;Kim, Ki-Bong;Kim, Yoon
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.365-368
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    • 2002
  • Background: Coronary artery bypass grafting(CABG) imposes large amount of medical costs, which are greatly affected by the surgical approach, quality of perioperative care and associated co-morbidities. Recently, off-pump CABG(OPCAB) has been introduced and performed with increasing frequency. To evaluate the efficacy of OPCAB in view of financial impact, we analyzed the costs and medical resources of OPCAB and compared with conventional CABG. Material and Method: From January 1998 to July 1999, 184 patients underwent CABG operation; 111 patients with OPCAB(group I) and 73 patients with conventional CABG(group II). We prospectively collected clinical data including risk factors and retrospectively reviewed the hospital resources. Result: Preoperative parameters including risk factors, postoperative mortality, morbidity and length of hospital stay were not different between the two groups, Duration of stay in the intensive care unit(ICU) (51.3 vs 128.3 hours, p<0.01) and ventilator, support time(14.9 vs 56.2 hours, p<0.01) were significantly shorter in the OPCAB group. Total hospital coats were 17,220,000 add 21,250,000(Korean Won) in group I and II, respectively(p<0.01). There were significant differences in operation fee, costs for operative materials, transfusion and diagnostic radiology between two groups. In group I, all the resources except diagnostic radiology were significantly decreased compared with group II. Conclusion: OPCAB has a beneficial effect on hospital charge and resource utilization. Shorter duration of the ICU stay and ventilatory support time may reduce the total hospital costs.

Does the Gut Microbiota Regulate a Cognitive Function? (장내미생물과 인지기능은 서로 연관되어 있는가?)

  • Choi, Jeonghyun;Jin, Yunho;Kim, Joo-Heon;Hong, Yonggeun
    • Journal of Life Science
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    • v.29 no.6
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    • pp.747-753
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    • 2019
  • Cognitive decline is characterized by reduced long-/short-term memory and attention span, and increased depression and anxiety. Such decline is associated with various degenerative brain disorders, especially Alzheimer's disease (AD) and Parkinson's disease (PD). The increases in elderly populations suffering from cognitive decline create social problems and impose economic burdens, and also pose safety threats; all of these problems have been extensively researched over the past several decades. Possible causes of cognitive decline include metabolic and hormone imbalance, infection, medication abuse, and neuronal changes associated with aging. However, no treatment for cognitive decline is available. In neurodegenerative diseases, changes in the gut microbiota and gut metabolites can alter molecular expression and neurobehavioral symptoms. Changes in the gut microbiota affect memory loss in AD via the downregulation of NMDA receptor expression and increased glutamate levels. Furthermore, the use of probiotics resulted in neurological improvement in an AD model. PD and gut microbiota dysbiosis are linked directly. This interrelationship affected the development of constipation, a secondary symptom in PD. In a PD model, the administration of probiotics prevented neuron death by increasing butyrate levels. Dysfunction of the blood-brain barrier (BBB) has been identified in AD and PD. Increased BBB permeability is also associated with gut microbiota dysbiosis, which led to the destruction of microtubules via systemic inflammation. Notably, metabolites of the gut microbiota may trigger either the development or attenuation of neurodegenerative disease. Here, we discuss the correlation between cognitive decline and the gut microbiota.

Development of an Eye Patch-Type Biosignal Measuring Device to Measure Sleep Quality (수면의 질을 측정하기 위한 안대형 생체신호 측정기기 개발)

  • Changsun Ahn;Jaekwan Lim;Bongsu Jung;Youngjoo Kim
    • KIPS Transactions on Computer and Communication Systems
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    • v.12 no.5
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    • pp.171-180
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    • 2023
  • The three major sleep disorders in Korea are snoring, sleep apnea, and insomnia. Lack of sleep is the root of all diseases. Some of the most serious potential problems associated with sleep deprivation are cardiovascular problems, cognitive impairment, obesity, diabetes, colitis, prostate cancer, etc. To solve these problems, the Korean government provided low-cost national health insurance benefits for polysomnography tests in July 2018. However, insomnia patients still have problems getting treated in terms of time, space, and economic perspectives. Therefore, it would be better for insomnia patients to be allowed to test at home. The measuring device can measure six biosignals (eye movement, tossing and turning, body temperature, oxygen saturation, heart rate, and audio). A gyroscope sensor (MPU9250, InvenSense, USA) was used for eye movement, tossing, and turning. The input range of the sensor was in 258°/sec to 460°/sec, and the data range was in the input range. Body temperature, oxygen saturation range, and heart rate were measured by a sensor (MAX30102, Analog Devices, USA). The body temperature was measured in 30 ℃ to 45 ℃, and the oxygen saturation range was 0% for the unused state and 20 % to 90 % for the used state. The heart rate measurement range was in 40 bpm to 180 bpm. The measurement of audio signal was performed by an audio sensor (AMM2742-T-R, PUIaudio, USA). The was -42 dB ±1 dB frequency range was 20 Hz to 20 kHz. The measured data was successfully received in wireless network conditions. The system configuration was consisted of a PC and a mobile app for bio-signal measurement and data collection. The measured data was collected by mobile phones and desktops. The data collected can be used as preliminary data to determine the stage of sleep and perform the screening function for sleep induction and sleep disturbances. In the future, this convenient sleep measurement device could be beneficial for treating insomnia.