• Title/Summary/Keyword: Cost control

Search Result 5,839, Processing Time 0.034 seconds

A Study on the Fabrication and Comparison of the Phantom for CT Dose Measurements Using 3D Printer (3D프린터를 이용한 CT 선량측정 팬텀 제작 및 비교에 관한 연구)

  • Yoon, Myeong-Seong;Kang, Seong-Hyeon;Hong, Soon-Min;Lee, Youngjin;Han, Dong-Koon
    • Journal of the Korean Society of Radiology
    • /
    • v.12 no.6
    • /
    • pp.737-743
    • /
    • 2018
  • Patient exposure dose exposure test, which is one of the items of accuracy control of Computed Tomography, conducts measurements every year based on the installation and operation of special medical equipment under Article 38 of the Medical Law, And keep records. The CT-Dose phantom used for dosimetry can accurately measure doses, but has the disadvantage of high price. Therefore, through this research, the existing CT - Dose phantom was similarly manufactured with a 3D printer and compared with the existing phantom to examine the usefulness. In order to produce the same phantom as the conventional CT-Dose phantom, a 3D printer of the FFF method is used by using a PLA filament, and in order to calculate the CTDIw value, Ion chambers were inserted into the central part and the central part, and measurements were made ten times each. Measurement results The CT-Dose phantom was measured at $30.44{\pm}0.31mGy$ in the periphery, $29.55{\pm}0.34mGy$ CTDIw value was measured at $30.14{\pm}0.30mGy$ in the center, and the phantom fabricated using the 3D printer was measured at the periphery $30.59{\pm}0.18mGy$, the central part was $29.01{\pm}0.04mGy$, and the CTDIw value was measured at $30.06{\pm}0.13mGy$. Analysis using the Mann - Whiteney U-test of the SPSS statistical program showed that there was a statistically significant difference in the result values in the central part, but statistically significant differences were observed between the peripheral part and CTDIw results I did not show. In conclusion, even in the CT-Dose phantom made with a 3D printer, we showed dose measurement performance like existing CT-Dose phantom and confirmed the possibility of low-cost phantom production using 3D printer through this research did it.

Application Effects of Biochar Derived from Pruned Stems of Pear Tree on Growth of Crops and Soil Physico-chemical Properties (배 전정지 바이오차 시용이 작물 생육 및 토양이화학성에 미치는 영향)

  • Jang, Jae-Eun;Lim, Gab-June;Park, Jung-Soo;Shim, Jae-Man;Kang, Chang-Sung;Hong, Sun-Seong
    • Journal of the Korea Organic Resources Recycling Association
    • /
    • v.26 no.4
    • /
    • pp.11-19
    • /
    • 2018
  • This study was conducted to develop the manufacturing method of biochar using pruned stems of pear tree and its application effect on the crop growth and soil physico-chemical properties. In this study, biochar derived from pruned stems of pear tree at heating temperature of $300^{\circ}C$, $500^{\circ}C$ and $700^{\circ}C$ in heating times of 2, 3 and 4 hours, were tested in the changes of their chemical properties during biochar processing. The pH, Exch. K, Exch. Mg and cation exchange capacity (CEC) increased as the pyrolysis temperature increased during the production of biochar, and the change of these properties rapidly occurred at $500^{\circ}C$. However, as the pyrolysis temperature increased, ash content increased and total carbon (T-C), yield decreased. And the change of the properties in response to the heating time was not shown. It was thought that it would be desirable to set the production conditions of biochar at $500^{\circ}C$ for 2 hours in consideration of the change of chemical properties and the ash content and yield. And also, were conducted the experiments to establish manufacturing method of farm-made biochar using drum biochar manufacturing machine and investigate the application effects of biochar on the cultivation of chinese cabbage and tomato. Application of biochar derived from pruned stems of pear tree could enhance pH, organic matter (OM), total carbon (T-C) of soil. On the other hand, soil electrical conductivity (EC), NO3-N were lowered compared to the control which has no application. The bulk density, porosity and aggregate formation of soil were improved by biochar application. The fresh matter yields of chinese cabbage and tomato were significantly increased in proportion to the application rate of biochar. This study demonstrated the effect of the biochar derived from agricultural byproduct to be as a low cost potential soil ameliorant by physico-chemical properties in eco-friendly greenhouse cultivation.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea

  • Kim, Chul;Sung, Jidong;Lee, Jong Hwa;Kim, Won-Seok;Lee, Goo Joo;Jee, Sungju;Jung, Il-Young;Rah, Ueon Woo;Kim, Byung Ok;Choi, Kyoung Hyo;Kwon, Bum Sun;Yoo, Seung Don;Bang, Heui Je;Shin, Hyung-Ik;Kim, Yong Wook;Jung, Heeyoune;Kim, Eung Ju;Lee, Jung Hwan;Jung, In Hyun;Jung, Jae-Seung;Lee, Jong-Young;Han, Jae-Young;Han, Eun Young;Won, Yu Hui;Han, Woosik;Baek, Sora;Joa, Kyung-Lim;Lee, Sook Joung;Kim, Ae Ryoung;Lee, So Young;Kim, Jihee;Choi, Hee Eun;Lee, Byeong-Ju;Kim, Soon
    • Journal of Chest Surgery
    • /
    • v.52 no.4
    • /
    • pp.248-329
    • /
    • 2019
  • Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Production of Medium-chain-length Poly (3-hydroxyalkanoates) by Pseudomonas sp. EML8 from Waste Frying Oil (Pseudomonas sp. EML8 균주를 이용한 폐식용류로부터 medium-chain-length poly(3-hydroxyalkanoates) 생합성)

  • Kim, Tae-Gyeong;Kim, Jong-Sik;Chung, Chung-Wook
    • Journal of Life Science
    • /
    • v.31 no.1
    • /
    • pp.90-99
    • /
    • 2021
  • In this study, to reduce the production cost of poly(3-hydroxyalkanoates) (PHA), optimal cell growth and PHA biosynthesis conditions of the isolated strain Pseudomonas sp. EML8 were established using waste frying oil (WFO) as the cheap carbon source. Gas chromatography (GC) and GC mass spectrometry analysis of the medium-chain-length PHA (mcl-PHAWFO) obtained by Pseudomonas sp. EML8 of WFO indicated that it was composed of 7.28 mol% 3-hydrxoyhexanoate, 39.04 mol% 3-hydroxyoctanoate, 37.11 mol% 3-hydroxydecanoate, and 16.58 mol% 3-hydroxvdodecanoate monomers. When Pseudomonas sp. EML8 were culture in flask, the maximum dry cell weight (DCW) and the mcl-PHAWFO yield (g/l) were showed under WFO (20 g/l), (NH4)2SO4 (0.5 g/l), pH 7, and 25℃ culture conditions. Based on this, the highest DCW, mcl-PHAWFO content, and mcl-PHAWFO yield from 3-l-jar fermentation was obtained after 48 hr. Similar results were obtained using 20 g/l of fresh frying oil (FFO) as a control carbon source. In this case, the DCW, the mcl-PHAFFO content, and the mcl-PHAFFO yields were 2.7 g/l, 62 wt%, and 1.6 g/l, respectively. Gel permeation chromatography analysis confirmed the average molecular weight of the mcl-PHAWFO and mcl-PHAFFO to be between 165-175 kDa. Thermogravimetric analysis showed decomposition temperature values of 260℃ and 274.7℃ for mcl-PHAWFO and mcl-PHAFFO, respectively. In conclusion, Pseudomonas sp. EML8 and WFO could be suggested as a new candidate and substrate for the industrial production of PHA.

Development of the paper bagging machine for grapes (휴대용 포도자동결속기 개발연구)

  • Park, K.H.;Lee, Y.C.;Moon, B.W.
    • Journal of Practical Agriculture & Fisheries Research
    • /
    • v.11 no.1
    • /
    • pp.79-94
    • /
    • 2009
  • The research project was conducted to develop a paper bagging machine for grape. This technology was aimed to highly reduce a labor for paper bagging in grape and bakery. In agriculture labor and farm population has rapidly decreased since 1980 in Korea so there was so limit in labor. In particular there is highly population in women and old age at rural area and thus labor cost is so high. Therefore a labor saving technology in agricultural sector might be needed to be replaced these old age with mechanical and labor saving tool in agriculture. The following was summarized of the research results for development of a paper bagging machine for grape. 1. Development of a new paper bagging machine for grape - This machine was designed by CATIA VI2/AUTO CAD2000 programme. - A paper bagging machine was mechanically binded a paper bag of grape which should be light and small size. This machine would be designed for women and old age with convenience during bagging work at the field site. - This machine was manufactured with total weight of less than 350g. - An overage bagging operation was more than 99% at the actual field process. - A paper bagging machine was designed with cartridge type which would be easily operated between rows and grape branches under field condition. - The type of cartridge pin was designed as a C-ring type with the length of 500mm which was good for bagging both grape and bakery. - In particular this machine was developed to easily operated among vines of the grape trees. 2. Field trials of a paper bagging machine in grape - There was high in grape quality as compared to the untreated control at the application of paper bagging machine. - The efficiency of paper bagging machine was 102% which was alternative tool for the conventional. - The roll pin of paper bagging machine was good with 5.3cm in terms of bagging precision. - There was no in grape quality between the paper bagging machine and the conventional method. - Disease infection and grape break was not in difference both treatments.

Suggestion of Community Design for the Efficiency of CPTED - Focused on Community Furniture - (범죄예방환경설계(CPTED)의 효율성 증대를 위한 커뮤니티디자인 제안 - 커뮤니티퍼니쳐를 중심으로 -)

  • Lee, Ho Sang
    • Korea Science and Art Forum
    • /
    • v.29
    • /
    • pp.305-318
    • /
    • 2017
  • The need for recognizing the crime in the urban spaces as a social problem and finding out specific approaches such as the study of space design and various guidelines for crime prevention is increasing. In this regard, "Crime Prevention Through Environmental Design" (marked as "CPTED") is actively underway. Yeomri-dong Salt Way is the first place to which the Seoul Crime Prevention Design Project was appled. The business objective of improving the local environment has been implemented rationally through cooperation and voluntary participation between subject of the project executives and community members. Since its efficiency has been proven, the sites have been expanded since then and becomes a benchmarking example of each local government.This kind of problem solving effort has the same context in purpose and direction of the 'Village Art Project' which has been implemented since 2009 with the aim of promoting the culture of the underdeveloped area and encouraging the participation of the residents by introducing the public art. It is noteworthy that this trend is centered around the characteristics of community functions and values. The purpose of this study is to propose the application method of community furniture as a way to increase the efficiency of CPTED to improve the 'quality of life' of residents. To do this, we reviewed CPTED, community design, public art literature and prior research, and identified the problems and implications based on the site visit Yeomri-dong of Seoul and Gamcheon Village of Pusan which is the successful model of "Seoul Root out Crime by Design" and 'Maeulmisul Art Project' respectively. The common elements of the two case places identified in this study are as follows: First, the 'lives' of community residents found its place in the center through the activation of community by collaborative activities in addition to the physical composition of the environment. Second, community design and introduction of public art created a new space, and thereby many people came to visit the village and revitalize the local economy. Third, it strengthened the natural monitoring, the territoriality and control, and the activity increase among the CPTED factors. The psychological aspect of CPTED and the emotional function of public art are fused with the 'community furniture', thereby avoiding a vague or tremendous approach to the public space through a specific local context based on the way of thinking and emotion of local people and it will be possible to create an environment beneficial for all. In this way, the possibility and implication of the fusion of CPTED and public art are expected to be able to reduce the social cost through the construction of the crime prevention infrastructure such as expansion of the CPTED application space, and to suggest a plan to implement the visual amenity as a design strategy to regenerate city.

Presenteeism in Agricultural, Forestry and Fishing Workers: Based on the 6th Korean Working Conditions Survey (농업, 임업 및 어업 종사자에서의 프리젠티즘: 제6차 근로환경조사를 바탕으로)

  • Sang-Hee Hong;Eun-Chul Jang;Soon-Chan Kwon;Hwa-Young Lee;Myoung-Je Song;Jong-Sun Kim;Mid-Eum Moon;Sang-Hyeon Kim;Ji-Suk Yun;Young-Sun Min
    • Journal of agricultural medicine and community health
    • /
    • v.49 no.1
    • /
    • pp.1-12
    • /
    • 2024
  • Objectives: Presenteeism is known to be a much more economically damaging social cost than disease rest while going to work despite physical pain. Since COVID-19, social discussions on the sickness benefit have been taking place as a countermeasure against presenteeism, and in particular, farmers and fishermen do not have an institutional mechanism for livelihood support when a disease other than work occurs. This study attempted to examine the relationship between agricultural, fishing, and forestry workers and presenteeism using the 6th Korean Work Conditions Survey. Methods: From October 2020 to January 2021, data from the 6th working conditions survey conducted on 17 cities and provinces in Korea were used, and a total of 34,981 people were studied. Control variables were gender, age, self-health assessment, education level, night work, shift work, monthly income, occupation, working hours per week, and employment status. Results: As a result of the analysis, farmers and fishermen showed the characteristics of the self-employed and the elderly, and as a result of the regression analysis, when farmers and fishermen analyzed the relationship with presenteeism tendency compared to other industry workers, farmers and fishermen increased by 23% compared to other industry groups. Conclusion: This study is significant in that it has representation by utilizing the 6th working conditions survey and objectively suggests the need for a sickness benefit for farmers and fishermen who may be overlooked in the sickness benefit.

Study on the Technological System of the Cooperative Cultivation of Paddy Rice in Korea (수도집단재배의 기술체계에 관한 연구)

  • Min-Shin Cho
    • KOREAN JOURNAL OF CROP SCIENCE
    • /
    • v.8 no.1
    • /
    • pp.129-177
    • /
    • 1970
  • For the purpose of establishing the systematized technical scheme of the cooperative rice cultivation which has most significant impact to improve rice productivity and the farm management, the author have studied the cultivation practices, and the variation of rice growth and yield between the cooperative rice cultivation and the individual rice cultivation at random selected 18 paddy fields. The author also have investigated through comparative method on the cultivation practices, management, organization and operation scheme of the two different rice cultivation methods at 460 paddy fields. The economic feasibility has been ana lysed and added in this report. The results obtained from this study are summarized as follows; 1. In the nursery, the average amount of fertilizer application, especially, phosphate and potassium, and the frequency of chemicals spray for the disease, insect and pest control at the cooperative rice cultivation are significantly higher than those of the individual rice cultivation. 2. The cultivation techniques of the cooperative rice farming after the transplanting can be characterized by a) the earlier transplanting of rice, b) the denser hills per unit area and the lesser number of seedlings per hill, c) the application of larger quantities of fertilizer including nitrogen, phosphate and potassium, d) more divided application of fertilizers, split doses of the nitrogen and potassium, e) the increased frequencies of the chemicals spray for the prevention of disease, insect and pest damages. 3. The rate of lodging in the cooperative rice cultivation was slightly higher than that of the individual rice cultivation, however, the losses of rice yield owing to the occurrence of rice stem borer and grass leaf roller in the cooperative rice cultivation were lower than that of the individual rice cultivation. 4. The culm length, panicle length, straw weight and grain-straw ratio are respectively higher at the cooperative rice cultivation, moreover, the higher variation of the above factors due to different localities of the paddy fields found at the individual rice cultivation. 5. The number of panicles, number of flowers per panicle and the weight of 1, 000 grains, those contributing components to the rice yield were significantly greater in the cooperative rice cultivation, however, not clear difference in the maturing rate was observed. The variation coefficient of the yield component in the cooperative cultivation showed lower than that or the individual rice cultivation. 6. The average yield of brown rice per 10 are in the cooperative rice cultivation obtained 459.0 kilograms while that of the individual rice cultivation brought 374.8 kilograms. The yield of brown rice in the cooperative rice cultivation increased 84.2 kilogram per 10 are over the individual rice cultivation. With lower variation coefficient of the brown rice yield in the cooperative rice cultivation, it can be said that uniformed higher yield could be obtained through the cooperative rice cultivation. 7. Highly significant positive correlations shown between the seeding date and the number of flowers per panicle, the chemical spray and the number of flowers per panicle, the transplanting date and the number of flowers per panicle, phosphate application and yield, potassium application and maturing rate, the split application of fertilizers and yield. Whilst the significant negative correlation was shown between the transplanting date and the maturing rate 8. The results of investigation from 480 paddy fields obtained through comparative method on the following items are identical in general with those obtained at 18 paddy fields: Application of fertilizers, chemical spray for the control of disease, insects and pests both in the nursery and the paddy field, transplanting date, transplanting density, split application of fertilizers and yield n the paddy fields. a) The number of rice varieties used in the cooperative rice cultivation were 13 varieties while the individual rice cultivation used 47 varieties. b) The cooperative rice cultivation has more successfully adopted improved cultivation techniques such as the practice of seed disinfection, adoption of recommended seeding amount, fall ploughing, application of red soil, introduction of power tillers, the rectangular-type transplanting, midsummer drainage and the periodical irrigation. 9. The following results were also obtained from the same investigation and they are: a) In the cooperative rice cultivation, the greater part of the important practices have been carried out through cooperative operation including seed disinfection, ploughing, application of red soil and compost, the control of disease, insects and pests, harvest, threshing and transportation of the products. b) The labor input to the nursery bed and water control in the cooperative rice cultivation was less than that of the individual rice cultivation while the higher rate of labor input was resulted in the red soil and compost application. 10. From the investigation on the organization and operation scheme of the cooperative rice cultivation, the following results were obtained: a) The size of cooperative rice cultivation farm was varied from. 3 ha to 7 ha and 5 ha farm. occupied 55.9 percent of the total farms. And a single cooperative farm was consisted of 10 to 20 plots of paddies. b) The educational back ground of the staff members involved in the cooperative rice cultivation was superior than that of the individual rice cultivation. c) All of the farmers who participated to the questionaires have responded that the cooperative rice cultivation could promise the increased rice yield mainly through the introduction of the improved method of fertilizer application and the effective control of diseases, insects and pests damages. And the majority of farmers were also in the opinion that preparation of the materials and labor input can be timely carried out and the labor requirement for the rice cultivation possibly be saved through the cooperative rice cultivation. d) The farmers who have expressed their wishes to continue and to make further development of the cooperative rice cultivation was 74.5 percent of total farmers participated to the questionaires. 11. From the analysis of economical feasibility on the two different methods of cultivation, the following results were obtained: a) The value of operation cost for the compost, chemical fertilizers, agricultural chemicals and labor input in the cooperative rice cultivation was respectively higher by 335 won, 199 won, 288 won and 303 won over the individual rice cultivation. However, the other production costs showed no distinct differences between the two cultivation methods. b) Although the total value of expenses for the fertilizers, agricultural chemicals, labor input and etc. in the cooperative rice cultivation were approximately doubled to the amount of the individual rice cultivation, the net income, substracted operation costs from the gross income, was obtained 24, 302 won in the cooperative rice cultivation and 20, 168 won was obtained from the individual rice cultivation. Thereby, it can be said that net income from the cooperative rice cultivation increased 4, 134 won over the individual rice cultivation. It was revealed in this study that the cooperative rice cultivation has not only contributed to increment of the farm income through higher yield but also showed as an effective means to introduce highly improved cultivation techniques to the farmers. It may also be concluded, therefore, the cooperative rice cultivation shall continuously renovate the rice production process of the farmers.

  • PDF

Study on the Thermal Storage Characteristics of Phase Change Materials for Greenhouse Heating (온실보온(溫室保溫)을 위한 상변화(相變化) 물질(物質)의 축열특성연구(蓄熱特性硏究))

  • Song, Hyun-Kap;Ryou, Young-Sun;Kim, Young-Bok
    • Solar Energy
    • /
    • v.13 no.2_3
    • /
    • pp.65-78
    • /
    • 1993
  • An overdose of fossil fuel for greenhouse heating causes not only the high cost and low quality of agricultural products, but also the environmental pollution of farm village. To solve these problems it is desirable to maximize the solar energy utilization for the heating of greenhouse in winter season. In this study phase change materials were selected to store solar energy concentratively for heating the greenhouse and their characteristics of thermal energy storage were analyzed. The results were summarized as follows. The organic $C_{28}H_{58}$, and the inorganic $CH_3COONa{\cdot}3H_2O\;and\;Na_2SO_4{\cdot}10H_2O$ were selected as low temperature latent heat storage materials. The equation of critical radius was derived to define the generating mechanism of the maximum latent heat of phase change materials. The melting point of $C_{28}H_{58}$ was $62^{\circ}C$, and the latent heat was $50.0{\sim}52.0kcal/kg$. The specific heat of liquid and solid phase was $0.54{\sim}0.69kcal/kg^{\circ}C$ and $0.57{\sim}0.75kcal/kg^{\circ}C$ respectively. The melting point of $CH_3COONa{\cdot}3H_2O$ was $61{\sim}62^{\circ}C$, the latent heat was $64.9{\sim}65.8$ kcal/kg and the specific heat of liquid and solid phase was respectively $0.83kcal/kg^{\circ}C$ and $0.51{\sim}0.52kcal/kg^{\circ}C$. The melting point of $Na_2SO_4{\cdot}10H_2O$ was $30{\sim}30.9^{\circ}C$, the latent heat was 53.0 kcal/kg and the specific heat of liquid and solid phase was respectively $0.78{\sim}0.89kcal/kg^{\circ}C$ and $0.50{\sim}0.7kcal/kg^{\circ}C$ When the urea of 21.85% was added to control the melting point of $Na_2SO_4{\cdot}10H_2O$ and the phase change cycles were repeated from 0 to 600, the melting point was $16.7{\sim}16.0^{\circ}C$ and the latent heat was $36.0{\sim}28.0kcal/kg^{\circ}C$.

  • PDF

A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
    • /
    • v.29 no.2
    • /
    • pp.48-65
    • /
    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

  • PDF