• Title/Summary/Keyword: Community-based Medical Service

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Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic (여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 -)

  • Park, Yeong-Suk
    • Women's Health Nursing
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    • v.5 no.1
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    • pp.133-145
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    • 1999
  • The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

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Current Status of Costs and Utilizations of Hospital Based Home Health Nursing Care in Korea (전국 의료기관 가정간호이용 및 가정간호비용)

  • Ryu, Ho-Sihn
    • Journal of Korean Academy of Nursing
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    • v.36 no.7
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    • pp.1193-1203
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    • 2006
  • Purpose: The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. Method: A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. Result: The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequoia of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won (${\fallingdotseq}$ 48 $, 1 $=960 Won). The costs ranged from 74,523 Won (${\fallingdotseq}$78 $, loss of chronic kidney function, N18) to 32,270 Won (${\fallingdotseq}$34 $, other cerebrovascular diseases, 167). Conclusion: Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.

A Study on Variable Geocasting in Ad-hoc Environment (Ad-hoc 환경에서의 가변 지오캐스팅에 관한 연구)

  • Lee Cheol-Seung;Kim Kuk-Se;Jung Sung-Ok;Lee Joon
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.510-513
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    • 2006
  • Mobile Ad-hoc networks have recently attracted a lot of attention in the research community as well as in industry. Although the previous research mainly focused on various of Ad-hoc in routing we consider, in this paper, how to efficiently support applications such as variable Geocasting basd on Ad-hoc networks. The goal of a geocasting protocol is deliver data packets to a group of nodes that are located within a specified geocasting region. Previous research that support geocast service in mobilie computing based on Ad-hoc have the non-optimization problem of data delivery path, overhead by frequent reconstruction of the geocast tree, and service disruption problem. In this paper, we propose the mobility pattern based geocast technique using variable service range according to the mobility of destination node and resource reservation to solve this problem. The experimental results show that our proposed mechanism has improved performance than previous research.

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A Population Health Characteristic Analysis of Willingness to Perform Cardiopulmonary Resuscitation (심폐소생술 수행 의지에 영향을 미치는 요인)

  • Kang, Kyung-Hee;Yim, Jun
    • Korean Journal of Health Education and Promotion
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    • v.25 no.4
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    • pp.43-54
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    • 2008
  • Objectives: To identify the willingness of laypersons to perform the cardiopulmonary resuscitation(CPR), we analyzed their characteristics of socio-economic status and health-medical conditions associated with their willingness. Methods: Based on a health survey of Incheon Metropolitan City adults(N=5,114), tests of the differences between a group with willingness to perform CPR(=1,531) and a group with non-willingness to perform CPR(=3,583), and a logistic regression analysis of two groups were executed on socio-economic status-gender, age, marital stats, education level, jobs, and monthly household income-and health-medical conditions-CPR-related self-confidence, CPR education, chronic diseases, accident experience, EMS(emergency medical service) experience, and health status. Results: The rate of the willingness group was 29.9%, which was relatively lower than other developed countries. There were statistically significant differences between the willingness group with the non-willingness group on gender, age, jobs, CPR-related self-confidence, CPR education, and so on. Furthermore, Gender, age, students or armed forces among jobs, CPR-related self-confidence, and CPR education were statistically significant influential factors on the willingness to perform CPR. Conclusion: This study indicated that there was considerable variation in socio-economic status and health-medical conditions associated with willingness to perform CPR in Incheon. The CPR education aimed at increasing CPR-related self-confidence and correcting inaccurate perceptions of CPR attitudes would promote its use in response to out-of-hospital cardiac arrest.

Korean Food Exchange Lists for Diabetes: Revised 2010 (2010 당뇨병 환자를 위한 식품교환표 개정)

  • Ju, Dal-Lae;Jang, Hak-Chul;Cho, Young-Yun;Cho, Jae-Won;Yoo, Hye-Sook;Choi, Kyung-Suk;Woo, Mi-Hye;Sohn, Cheong-Min;Park, Yoo-Kyoung;Choue, Ryo-Won
    • Journal of Nutrition and Health
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    • v.44 no.6
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    • pp.577-591
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    • 2011
  • A food exchange system for diabetes is a useful tool for meal planning and nutritional education. The first edition of the Korean food exchange lists was developed in 1988 and the second edition was revised in 1995. With recent changes in the food marketplace and eating patterns of Koreans, the third edition of food exchange lists was revised in 2010 by the Korean Diabetes Association, the Korean Nutrition Society, the Korean Society of Community Nutrition, the Korean Dietetic Association and the Korean Association of Diabetes Dietetic Educators through a joint research effort. The third edition is based on nutritional recommendations for people with diabetes and focuses on adding foods to implement personalized nutrition therapy considering individual preferences in diverse dietary environment. Foods were selected based on scientific evidence including the 2007 Korea National Health and Nutrition Examination Survey data analysis and survey responses from 53 diabetes dietetic educators. While a few foods were deleted, a number of foods were added, with 313 food items in food group lists and 339 food items in the appendix. Consistent with previous editions, the third edition of the food exchange lists included six food categories (grains, meat, vegetables, fats and oils, milk, and fruits). The milk group was subdivided into whole milk group and low fat milk. The standard nutrient content in one exchange from each food group was almost the same as the previous edition. Korea Food & Drug Administration's FANTASY (Food And Nutrient daTA SYstem) database was used to obtain nutrient values for each individual food and to determine the serving size most appropriate for matching reference nutrients values by each food group. The revised food exchange lists were subjected to a public hearing by experts. The third edition of the food exchange lists will be a helpful tool for educating people with diabetes to select the kinds and amounts of foods for glycemic control, which will eventually lead to preventing complications while maintaining the pleasure of eating.

Application of Picture Book Reading Training Protocol using Electronic Media and Its Effects on Reading Ability for to Borderline Intellectual Children (경계선 지능 아동을 대상으로 전자매체를 활용한 그림책 읽기 훈련 프로토콜의 적용 및 읽기능력에 미치는 영향)

  • Son, Sung-Min;Kwag, Sung-Won;Jeon, Byoung-Jin
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.3
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    • pp.25-35
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    • 2018
  • Objective : The purpose of this study was to identify changes in reading ability among children with Borderline Intelligence by applying an electronic media reading training protocol. Methods : A picture book reading training protocol was applied to 10 childrens with borderline intelligence using electronic media to improve reading skills. This protocol was performed for 10 session once a week. After the analysis of the content validity index about the protocol presented in this study, this prococol was applied to the subjects. To analyze the changes of the reading ability for the subjects, KNISE-BAAT type A and B reading test were used. Results : According to the tests taken before and after implementing, the Application of Picture Booking Training Protocol using Electronic Media there was a significant improvement in Reading ability (Understanding words, Completion sentence, Vocabulary selection, Vocabulary arrangement, Understanding short text). However, there was no significant difference in Oral Reading. Conclusion : Application of Picture Booking Training Protocol using Electronic Media may be used as a beneficial measure to improve the reading abilities of children with Borderline Intellectual.

Priority Areas for National Health Care Quality Evaluation in Korea (의료의 질 평가 우선순위 설정)

  • Shin, Suk-Youn;Park, Choon-Seon;Kim, Sun-Min;Kim, Nam-Soon;Lee, Sang-Il
    • Health Policy and Management
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    • v.19 no.3
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    • pp.1-26
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    • 2009
  • Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

The Effect Nursing Organizational Culture on the Quality of Nursing Service: Mediating Effect of Work Engagement (간호사가 지각하는 간호조직문화가 간호서비스의 질에 미치는 영향: 직무열의의 매개효과를 중심으로)

  • Hong, Eun-Jeong
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.6
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    • pp.31-40
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    • 2022
  • This study is a descriptive research study to confirm the mediating effect of job engagement on the relationship between the nursing organizational culture and the quality of nursing service perceived by nurses. The research subjects and data were collected from June 1 to June 7, 2022, and 215 nurses working at hospital-level or higher medical institutions recruited through the online community for nurses. As a result of the study, Relation orientated culture(Z=3.88, p<.001) and Task orientated culture(Z=3.16, p=.001) affected the quality of nursing service, and it was found that job engagement fully mediating effect. Hierarchical orientated culture (Z=2.39, p=.017) affected the quality of nursing service, and it was found that job engagement had a partial mediating effect. Therefore, in order to improve the quality of nursing services, it is necessary and to promote work engagement by forming a culture to establish a trust relationship among members based on the order and procedure for safety in nursing sites that require rapid and accurate response in emergency situations and performing tasks efficiently to achieve organizational goals.

Development and Effectiveness of Occupation Based Grocery Shopping Skill Training Program For The Person with Developmental Disability (거주시설 발달장애인을 위한 작업 기반 마트장보기 훈련 프로그램의 개발 및 효과)

  • Ju, Yu-mi;Kim, Dea-Yoon;Mo, Young-Ho;Son, Sung-Min
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.3
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    • pp.43-58
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    • 2017
  • Objectives : The Purpose of this study was to develop the occupation based grocery shopping skill training program for group of person with developmental disability and to test its effect. Methods : We set the grocery shopping task for the theme of the program and we applied this program for 9 sessions. There were initial, final, and follow-up evaluation and training sessions were provided 6 times. In the every session, group training program for grocery shopping skills was conducted. The performance of grocery shopping skills was evaluated by Test of Grocery Shopping Skills(TOGSS). Results : At the final assessment of grocery shopping skill, there were increased performance skills especially in item collection and size comparison. Among 3 subjects, two showed in improved navigation skills in order to search for target items. However, there was no improvement in comparing the optical price of items. For the last, it was significant that the total time to spend for shopping were commonly decreased. The performance of grocery shopping were maintained in 2 subjects and another subject was unable to perform it at the 5 month later follow-up evaluation. Conclusion : The occupation based grocery shopping skill training group program which was developed in this study is useful guide-line for occupational therapists who seek for the community based program. All 3 subjects showed the improved performance on shopping skill through this program.

Test on the Cost and Development on the Payment System of Home Health Care Nursing (가정간호수가 적정성 검증 및 수가체계 개선 방안)

  • Ryu Ho-Sihn;Jung Key-Sun;Lim Ji-Young
    • Journal of Korean Academy of Nursing
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    • v.36 no.3
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    • pp.503-513
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    • 2006
  • Purpose: This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes. Method: The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies. Result: The cost of home health care nursing per visit was calculated as 50,626\. This was composed of a basic visiting fee of $35,090{\\}({\fallingdotseq}355$)$ and travel fee of $15,536{\\}({\fallingdotseq}15$)$. The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services. Conclusion: This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.