The Korean government has a new system for charging patient care for patients in hospital, on hold for the present(9 / 1995) but to start implementation in certain areas of patient care next year. From the latter half of next year the Ministry of Health and Welfare would like to start demonstration projects for hospitals who want to start using DRGs for frequently seen medical diagnosis and for patients with a course that is predictable and for whom non-insurance costs are minimal : such as the patient who has a delivery, cesarean deliveries, cataract surgery, tonsillectomy or an appendectomy, and apply the DRG system of payment for hospital care for these patients. The purpose of this study was to establish a recording system to give effective home health care to postpartum women and their newborns. Recently the government announced a DRG system to apply to postpartum women for pilot purposes starting next year. This gives impetus to the need to develop home care records that will allow for systematic recording and provide continuity and consistency in care across all health professionals and with in-depth communication between the professions to assure high quality care. There has been a rise in medical costs and a shortage of patient bed space in hospitals, particularly since the introduction of national medical insurance. The study focused on developing client selection criteria, a primary assessment tool, progress notes and nursing diagnoses applicable to postpartum and newborn clients. Selection criteria for home health care, assessment tool content, nurses progress notes and diagnoses were developed through a review of the literature, advice from professionals who are expert in home health care and actual practice in the use of recording tools through workshops. The recommendations based on the research results are as follows : 1) Replication and application of these tools is needed to test the validity of the tools 2) In order to have systematic nursing records standardization of records has to be done after nurses have had experience using them. 3) Reliability and validity of the tools has to be established through applicability to actual care situation.
Lee, Kug Jong;Kim, Jae Yong;Lee, Kang Hyun;Suh, Gil Joon;Youn, Yeo Kyu
Journal of Trauma and Injury
/
v.18
no.1
/
pp.1-16
/
2005
An ideal trauma care system would include all the components identified with optimal trauma care, such as prevention, access, acute hospital care, rehabilitation, and research activities. Central to an ideal system is a large resource-rich trauma center. The need for resources is primarily based on the concept of being able to provide immediate medical care for unlimited numbers of injured patients at any time. Optimal resources at such a trauma center would include inhouse board-certified emergency medicine physicians, general surgeons, anesthesiologists, neurosurgeons, and orthopedic surgeons. Other board-certified specialists would be available, within a short time frame, to all patients who require their expertise. This center would require a certain volume of injured patients to be admitted each year, and these patients would include the most severely injured patients within the system. Additionally, certain injuries that are infrequently seen would be concentrated in this special center to ensure that these patients could be properly treated and studied, providing the opportunity to improve the care of these patients. These research activities are necessary to enhance our knowledge of the care of the injured. Basic science research in areas such as shock, brain edema, organ failure, and rehabilitation would also be present in the ideal center. This trauma center would have an integrated concurrent performance improvement program to ensure optimal care and continuous improvement in care. This center would not only be responsible for assessing care delivered within its trauma program, but for helping to organize the assessment of care within the entire trauma system. This ideal trauma center would serve as a total resource for all organizations dealing with the injured patient in the regional area.
Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.
The purposes of this study were to examine the perception of directors and child care providers regarding the Seoul-type Child Care Accreditation and its operating system. The objects were 309 directors and child care providers at accredited Seoul-type child care centers. The collected data was analyzed using frequency, percentiles, and ${\chi}^2$. The results are as follows: First, the majority of directors and child care providers perceived 'the preparation for effective quality control of child-care service' as the primary purpose of the Seoul-type Child Care Accreditation. Many of them responded that the child care centers meeting the purpose of accreditation would be 'private' and 'home-based' ones. Seoul-type Child Care Accreditation was easier to pass compared to National Child Care Accreditation. The directors and child care providers perceived that the accreditation will narrow the gap between public and private child care centers. Second, in operating customized child-care service, most directors preferred 'submits only the same plan as that of a designated one', but most child care providers preferred 'assessment after providing customized child-care'. For the reliable child-care service and accounting management system, both subject groups showed general satisfaction with 'current system'. Third, both subject groups responded that 'overtime pay for child care providers' and 'government's consistent child-care policy' were what they desire most to improve Seoul-type Child Care Accreditation.
This study was performed to investigate health care system satisfaction and reform need using the data from the '2019 Health Care Experience Survey'. For 8,349 data with experience in medical use, health care system satisfaction and reform need level was analyzed by t-testing and ANOVA by characteristics of the study subjects, and multiple regression was conducted. Research has shown that health care users' recognition of the health care system is relatively low compared to reliability and satisfaction. It is necessary to promote policies and health care systems for senior citizens, low education levels. Since the reliability has the biggest impact on the satisfaction of the health care system, government should establish policies that they can trust, and in the process, they should gather opinions from the public and secure credibility through social consensus. Medical users were sympathetic to the need for reforms in the health care system, and felt the need to support vulnerable areas and vulnerable groups the most.
This paper analyzed four different perspectives on health care reform in Korea in terms of the basic values, formulated problems and reform plans, implementation methods, and supporting groups. The medical security plan was insisted by social security specialists and social activists focusing on the integration of medical insurance coops in order to enhancing equity and right of the people. However, its perspective was limited to promoting security instead of reforming health care system. The government proposed the health care reform plans in 1994 and in 1997, focusing on promoting efficiency by remedying many problems in health care delivery system. However, its implementation was not successful due to the lack of organizational and financial supporters. Recently, two opposite proposals were issued. The market reform plan paid attention to revitalizing the market function to promoting efficiency by allowing hospitals to treat private patients instead of applying the medical insurance regulation. The government reform plan focused on intensifying governmental planning and intervention in the health care sector in order to removing inefficiency and promoting equity with the supports of social activists and labor unions. Finally, this paper proposed an alternative plan to promote harmonious social relationship between actors in the health care system.
Computerization has been applied in most areas of health care in recent years. But computerized standardized nursing care plans have not yet been adequately developed even though they can significantly contribute to an improvement in the quality of nursing care. Therefore, this study was done to develop computerized nursing care plans. For this purpose, the study had the following objectives ; 1) to develop a computerized program for standardized nursing care plans which include defining characteristics, relating factors, expected out-comes and nursing interventions 2) to test applicability of the computerized pro-grams to the actual clinical situation of the clinical nurse. Application of the system development life cycle by davis was used as the study methodology. There are five stages in this method : strategy planning development, system analysis, system design, system practice and system evaluation. The first four steps in this methodology were used in this project. Two clinical nurses were selected to apply this computerized program in the clinical situation. The results of the study are as follows ; 1) Ten standardized nursing care plans including defining characteristics, relating factors, expected outcomes and nursing interventions which had been proven to have validity in the clinical setting were computerized using the Foxbase Program. 2) These programs were applied to the actual clinical situation by two clinic친 nurses working at Severance Hospital. For further study, continuous revision should be done by the users. Evaluation related to the utilization of the program should also be done.
Purpose: This research was a survey to ascertain whether there are differences in opinion about designated doctors and hospitals, type of health care service utilized and health behavior between people who have applied to be Medical Aid Beneficiaries, but not using the Designated Doctor System. Method: The participants were from three groups, application for two years, one year and non-appliers. Data collection was done by Medical Care Client Managers through in-depth interviews using a structured questionnaire. Results: The participants expressed no negative effect of the designated doctor system in relation to designated doctor, hospital or health behavior but there was a significant effect in type of health care service utilized. Conclusion: In the future, the commitment of Medical Care Client Managers is important, but the role of health care providers will be emphasized in order to sustain the effectiveness of the health care system under the Designated Doctor System.
Purpose: A survey was conducted to investigate the role, priority, and awareness of physical therapists in the community care system for the elderly. Methods: Nine hundred ninety-three physical therapists were invited to an online survey from 1st to 30th June 2020. Results: While the awareness of physical therapists for the community care system for the elderly was found to be low, the role priority and performance ability were found to be high. Fall training scored the highest for the job duties of physical therapists, and functional training scored the highest for the performance ability of physical therapists. For the role priority by the education status regarding the community care system, the participants who received the education program showed higher scores in the performance ability than those who did not. For the role priority and performance ability according to the education levels, higher education levels resulted in higher scores in both outcomes. Regarding the clinical experience, low scores were found in the participants with less than five years of experience. Conclusion: Physical therapy establishes itself as an essential area of expertise in the community care system for the elderly. Therefore, these results can be utilized in developing a model for Korean community care for the elderly.
Purpose: COVID-19 infections have been erupting in places of worship, long-term care facilities, and call centers in Korea since January 2020. This study aims to diagnose and present an infection control system solution for long-term care facilities where at-risk elderly individuals are actively engaged in communal life. Methods: We conducted comparative analyses of infection control systems between long-term care facilities and medical institutions respective of relevant laws and this study's evaluation system. Results: To prepare for future infectious diseases, it is necessary to establish a long-term care facility infection control system and strengthen the standards thereof, to strengthen long-term care facility evaluation standards and to newly establish medical charges for infection control. Conclusion: Systematic procedure fortification and financial support provisions are necessary for infection control at long-term care facilities.
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