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Assisted Outpatient Treatment and Crisis Intervention in USA and their Implications for Korea (미국의 외래치료명령제도 및 위기대응과 국내적 시사점)

  • Park, Inhwan;Han, Meekyung
    • The Korean Society of Law and Medicine
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    • v.19 no.1
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    • pp.23-80
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    • 2018
  • Since the 1960s, the United States' (U.S.) deinstitutionalization policy has reinstated people with mental illness into communities. Unfortunately, when untreated, some people with psychiatric disorders become homeless, and some commit serious crimes during a psychological crisis. Assisted Outpatient Treatment (AOT), also known as Kendra's Law in New York and Laura's Law in California, provides treatment, services and support to people with mental illness in the community. AOT has repeatedly been found effective and is recognized as an evidence-based practice. The response to the mental health crisis (crisis intervention) in the U.S. has also been successful in preventing worsening mental illness and related criminality and other issues. This paper provides an opportunity to create a platform from which to learn how to successfully apply the AOT and crisis intervention of the U.S. to South Korea within the cultural and societal context when establishing social services for people with mental illness in South Korea's communities.

A Study on Monitoring of Bio-Signal for u-Health System (u-Health System을 위한 생체신호 모니터링에 관한 연구)

  • Han, Young-Hwan
    • Journal of the Korea Society of Computer and Information
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    • v.16 no.3
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    • pp.9-15
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    • 2011
  • U-healthcare system has an aim to provide reliable and fast medical services for patient regardless of time and space by transmitting to doctors a large quantity of vital signs collected from sensor networks. Existing u-healthcare systems can merely monitoring patients' health status. In this paper, we describe the implementation and validation of a prototype of a u-health monitoring system based on a wireless sensor network. This system is easy to derive physiologically meaningful results by analyzing rapidly vital signs. The monitoring system sends only the abnormal data of examinee to the service provider. This technique can reduces the wireless data packet overload between a monitoring part and service provider. The real-time bio-signal monitoring system makes possible to implement u-health services and improving efficiency of medical services.

Improvement of Management of Long-Term Care Facilities Through FGI (FGI를 통한 노인장기요양시설 운영 개선 방향에 관한 연구)

  • Park, Sung Won;Lee, Won Jae
    • The Journal of the Korea Contents Association
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    • v.19 no.1
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    • pp.587-597
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    • 2019
  • With the rapid aging of the nation's population and the increasing number of elderly people with difficulties in daily life, the elderly care system was implemented for social solidarity. Structural problems in the long-term care system that emerged after the introduction of the system are demanded, and the problem of functional readjustment between nursing hospitals and facilities is raised due to the lack of continuity of care for the elderly by institutional and salary types. In this study, we set up research problems related to personnel, staff, and services to address the problem and conducted FGI. Research has shown that the number of elderly and recognized people in the region, the number of elderly and elderly patients, needs to be reflected in long-term care demand, the direction of appropriate institutional and manpower supply policies, and the establishment of local government goals and plans to strengthen the long-care institutions. It was revealed that non-medical accident arbitration bodies are needed to apply the cost of food insurance, provide programs through links with relevant institutions, and manage the admission smoothly.

Current State and the Future Tasks of Home Visit Nursing Care in South Korea (우리나라 가정방문간호의 현황과 향후 과제)

  • Park, Eunok
    • Journal of agricultural medicine and community health
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    • v.44 no.1
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    • pp.28-38
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    • 2019
  • Objectives: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. Method: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. Results: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. Conclusion: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.

Occupational Stress and Emotional Intelligence in Hospice Volunteers (호스피스 자원봉사자의 직무 스트레스와 감성지능 간의 관계)

  • Kim, Yeon Ha;Kim, Minju
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.112-119
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    • 2015
  • Purpose: The purpose of this study was to explore the level of occupational stress and emotional intelligence in hospice volunteers. Methods: Participants were 158 hospice volunteers at hospitals in B city. Occupational stress, emotional intelligence, and general characteristics of hospice volunteers were measured. The data were analyzed with descriptive statistics, t-tests, ANOVA, and Pearson's correlation coefficients. Results: The mean score for occupational stress was 2.16 points out of 4 and 4.65 out of 7 for emotional intelligence. The scores for occupational stress and emotional intelligence were significantly different by educational level and monthly income in hospice volunteers. Occupational stress was negatively correlated with emotional intelligence (r=-0.196, P=0.013). Conclusion: A continuous educational program is needed to offer volunteers with new hospice-related trends. To ensure quality care for patients and their families, it should be helpful to encourage hospice volunteers to build a social network to enhance their emotional intelligence.

Health Economic Approach to End-of-Life Care in the US: Based on Medicare (말기의료의 경제적 요소에 관한 논의: 미국 메디케어 상황을 중심으로)

  • Suk, Ryan
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.335-373
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    • 2014
  • According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

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System for Real-Time Analysis of Body Posture of Home Inhabitant by Using a Tilt Sensor (기울기 센서를 이용한 홈 거주자의 실시간 자세분석 시스템)

  • Cha, Joo-Heon;Jun, Sung
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.35 no.2
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    • pp.135-141
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    • 2011
  • A smart home provides services that its inhabitant needs or wants, by integrating and simultaneously controlling various devices and sensors. In this study, we focused on a smart-home system for people with disabilities and for elderly people. We introduced a new type of system for real-time analysis of body posture of the inhabitants of a smart home. The system includes the concept that offers remote healthcare or medical services by using a 3D tilt sensor for recognizing the static and dynamic postures of inhabitants in real time. It consists of a smart-home server and a 3D tilt sensor, and it uses wireless technology to communicate with the inhabitants and thus enhance their mobility. The smart-home server includes the inference engine that differentiates the dynamic postures from the static ones. Finally, we also demonstrate the usefulness of the proposed system by applying it to a real environment.

Factors Influencing the Unmet Healthcare Needs of Elderly with Chronic Diseases : Focusing on the 2017 Korean National Survey on Elderly (노인 만성질환자의 미충족 의료에 영향을 미치는 요인 : 2017년도 노인실태조사를 중심으로)

  • Park, Ji-Kyeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.12
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    • pp.306-313
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    • 2019
  • This study endeavors to provide basic data for healthcare policy development by identifying factors that influence the unmet healthcare needs of the elderly with chronic diseases. The study utilized data from the 2017 Korean National Survey on the Elderly, and analyzed 9,117 elders afflicted with more than 1 chronic disease. We determined that 851 (9.3%) elders experienced unmet healthcare needs from hospital & clinical treatment, and 1,469 (16.1%) elders experienced unmet dental treatment. 'Economic difficulty' was the most common reason expressed by 425 (49.9%) elders for unmet healthcare needs from hospital and clinical treatment, and by 1,066 (72.6%) elders for dental treatment. Furthermore, unmet healthcare needs in hospital and clinical treatment were affected by various factors, including spouse, education, self-rated health status and exercise, whereas unmet healthcare needs in dental treatment were affected by factors such as spouse, education, medical aids, self-rated health status, smoking, and exercise. Based on the research results achieved, we propose a necessity to establish healthcare policies that consider the influencing factors, and help resolve the unmet healthcare needs of the elderly with chronic diseases.

Analysis on Working Force Supply of Radiologic Technologist in Korea (국내 방사선사 인력수급 현황 분석)

  • Choi, Kyoungho;Cho, Jung Keun
    • Journal of Digital Convergence
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    • v.15 no.7
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    • pp.489-495
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    • 2017
  • To prevent over supplying of workforce with radiologic technologist license, effort to create new jobs related to radioactive from medical field and radiation-related academia should be put first. For this, investigating present condition is required by close analysis of working force supply related to radiation. Therefore in this research, basic data useful for developing future radiation-related policy and plan is provided from analysis of present supplying condition of radiologic technologists in Korea. Results are as following. First, number of people qualified as radiologic technologists consistently increased; 15,639 more people took the license in 2014 compared with 2004, showing growth rate of 75.6%. Second, about 65.7%, most of workforce related to radiation engaged in medical area. Third, estimating supply and demand of radiologic technologists by time period of 5 years from 2015 to 2040, about 6,000 number of surplus work force was predicted around 2020. Fourth, satisfaction of graduates who majored in radiology was quite low for their first occupation. These results implicate necessity of systemic supplementation which can expand medical areas where radiologic technologists can work.

The Design of Messaging System for Prescription Data Interchange (처방전달을 위한 메시징시스템의 설계)

  • 김동호;류근호;손현준
    • Proceedings of the Korea Society for Industrial Systems Conference
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    • 1999.12a
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    • pp.209-218
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    • 1999
  • 처방전달시스템은 처방의 수행은 의사가, 그에 따른 의약품조제는 약사가 수행함으로써 의약품의 오․남용을 방지하기 위한 의약분업의 실시에 따른 국민불편의 최소화와 약화사고에 따른 인증문제 등을 지원하기 위한 정보시스템이다. 처방전달시스템은 환자 개인정보의 허용된 범위 내에서의 공유와 공유를 위한 각종 개인정보 보호장치, 처방의 안전한 전달을 위한 내용의 비밀보장과 위변조방지 및 송신자와 수신자의 인증을 위한 장치가 필수적으로 필요하다. 또한 자료의 생명주기 측면에서 본다면, 처방전의 생성은 병․의원에서 이루어지며 소멸은 약국 및 환자에의해 이루어진다. 자료의 유통과정에 살펴보면 처방전달시스템의 주요성공요인은 정보의 생산자인 병․의원(의사)의 적극적인 정보제공의지와 이를 지원하는 편리한 정보시스템의 구축이라고 할 수 있다. 정보의 생산자인 병․의원 정보시스템 환경은 다양하고 복잡하기 때문에 기존의 애플리케이션을 이용하면서 처방의 전송을 위해서는 기존 애플리케이션 및 플랫폼에 독립적이며 자료의 적합한 취합과 통합이 가능하도록 지원하는 시스템이 필요하다. 처방전달 메시징시스템은 이러한 복합적인 정보시스템 환경을 지원하며 동시에 처방정보의 안전한 전달을 위해 플랫폼으로 실행될 수 있는 시스템을 말한다. 또한 처방의 비교적 짧은 생명주기와 지역적 생산, 유통구조를 적합하게 지원하기 위해 지역별 독립시스템의 구축과 공통정보 활용을 위한 중앙시스템과의 역할분담 모델에 근거한 분산시스템의 구축이 요구된다. 본 연구에서의 처방전달 메시징시스템은 일반적인 메시지서비스의 특성을 기본으로 자료전달을 위해 자료 암호화와 복호화, 송신자와 수신자에 대한 인증 및 자료접근 제한기능을 제공하며 각 클라이언트와 서버간의 실시간 연결 혹은 지연연결을 지원하는 독립적인 애플리케이션이다. 이러한 처방전달 메시징시스템을 구성하는 각 요소에 대해 정의하고 개념적 모델을 설계하고자 한다.에게 청구되며, 소비자에게 전송 되는 청구서는 사용자DB를 참조하여 사용자가 미리 정의한 원하는 형태로 변환되어 전달되며, 필요시 암호화 과정을 거치는 것이 가능해야 한다. 전송된 청구서는 전자우편의 경우, 암호해독이 가능한 전용 브라우저를 통해 열람 되며, 이는 다시 전용 브라우저를 통해 지불인증이 승인되어 청구 제시서버에게 전송된다. EBPP 시스템의 제어 흐름은 크게 기업이 청구 정보를 소비자에게 제시하는 흐름과 소비자의 지불 승인으로 인해 기업이 은행에 지불을 요구하는 흐름으로 구분할 수 있다. 본 논문에서는 통합 청구서버 및 정구 제시서버의 역할 및 구성 요소들에 대해 서술하고, EBPP 시스템과 연동하여야 하는 메일 서버와의 상호 작용에 대해 서술할 것이다. 본 시스템을 아직 구현이 되지 않은 관계로 시스템의 성능 등의 수치적 결과를 제시할 수 없는 상태다., 취약계층을 위한 일차의료, 의약관리), ${\circled}2$ 보건소 조직 개편 및 민간의료기관과 협력체계 확립, ${\circled}3$ 전문인력 확보 및 인력구성 조정, 그리고 ${\circled}4$ 방문보건사업의 강화 등이다., 대사(代謝)와 관계(關係)있음을 시사(示唆)해 주고 있다.ble nutrient (TDN) was highest in booting stage (59.7%); however no significant difference was found among other stages. The concentrations of Ca and P were not different among mature stages. According to these results, the yellow ripe period is appropriate to harvest the whole crop rice for forage considering dry matter yields,

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