• Title/Summary/Keyword: Delivery care

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A Study on the Effectiveness of Skin Care Solution System using Non-Invasive Air Technology

  • Park, Do-Young;Yoon, Dong-Gon;Seo, Jung-Gil
    • Journal of Platform Technology
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    • v.10 no.3
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    • pp.3-10
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    • 2022
  • The effectiveness of an innovative skin treatment system that delivers an anti-aging solution deep into the skin without invasiveness and pain using a non-invasive air technology was investigated. In addition, an effective change using a non-invasive technique for delivering a solution for skin improvement was confirmed. The equipment named Cellre Jet is an effective skin care and drug delivery equipment that instantly opens the skin epidermis by using a maximum output pressure of 6 bars and high-pressure purified oxygen of 75-90% purity to deliver various nano-sized vital substances deep into the skin, and it uses the method of precisely controlling the equipment through an 8-inch digital touch display to accurately dispense the prescribed dosage. In this study, changes in skin condition were analyzed using this equipment and nano ampoules on subjects with actual skin problems through a related comparison and effectiveness judgment program. Through this study, skin care and drug delivery are possible, which will contribute to verifying the effectiveness of this non-invasive drug delivery equipment in the future, and is expected to establish the systematic effect in observing and studying changes in the skin.

Establishment of Healthcare Delivery System through Improvement of Health Insurance System (건강보험수가제도 개선을 통한 의료전달체계 확립방안)

  • Oh, Youngho
    • Health Policy and Management
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    • v.29 no.3
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    • pp.248-261
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    • 2019
  • Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

A Case Analysis of Home Health Care for Cesarean Postpartum Women and Their Newborns (제왕절개분만 산욕부와 신생아의 가정간호 사례분석)

  • 김혜숙;최연순;전은미
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.696-705
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    • 1994
  • This study was done to provide a basis for home health care management for women following Cesarean delivery. Furthermore it was initiated as an possible application of home health care in the future. In this study, client selection criteria was developed by the researcher and assessment tools for home health care, recording system and problem oriented recording system were revised from Jun's(1993) methods. The selection criteria tool for home health care for women who had a Cesarean delivery was structured and consisted of five areas : physical status, functional status, psychological-emetional status, educational needs status and environmental status. The structured assessment tool consisted of general items, obstetric history, past medical history, methods of feeding, medications taken before ad-mission, laboratory results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of women and their newborns. The visit note consisted of the date : nursing problems : nursing process including initial assessment : nursing goals : visit plan : health status of the postpartum women and their newborn : nursing diagnoses : nursing implementation evaluation : summary : next visit plan and revision. The problem oriented recording system consisted of the date, problem numbers, nursing diagnoses, problem appearance date, problem resolution date. The results of the research are as follows : The seven cases having had a Cesarean delivery were discharged on an average on the 5th day after the Cesarean birth. The total number of home visits was 13. According to Cordon's functional health patterns the total possible nursing diagnoses was 34 diagnoses for the methers and their newborns. Among the 34 diagnoses, there were 13 diagnoses in the health perception /management pattern, 7 in the psychosocial health perception / management pattern, 8 in the psychosocial self-perception, 2 in the nutrition / metabolism pattern of physical function, 2 in the knowledge deficit of newborn management, anxiety related to newborn management, knowledge deficit related to disease process of new-born, anxiety related to disease process of newborn anxiety related to prognosis of baby's condition, knowledge deficit related to newborn jaundice each appeared once. The changes in the number of nursing diagnoses was related to not the number of visits but to the number of nursing diagnoses decreasing. The con-tent of the home health care was categorized ac-cording to assessment, direct care, counseling, education, family care. The recommendation based on the results of this research are Home health care nurses for Cesarean postpartum women and their neonates requires comprehensive knowledge of pregnancy, delivery, and the postpartum period and of the neonate so that they can provide appropriate care and holistic views. Most of cases terminated after the second visit, this outcome may be related to the subjects being discharged on the 5th day after delivery. Therefore, study done with earlier discharge after delivery may have different outcome. It is very hard to assess psychological aspects that need follow-up and to develop communication channels.

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A Comparison of Medical Care Services by Type of Medical Care Facility -In cases of normal spontaneous vaginal delivery and acute appendicitis- (의료기관 종류별 진료내역 비교 -정상분만과 급성 충수염을 중심으로-)

  • Lee, Young-Doo
    • Journal of Preventive Medicine and Public Health
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    • v.18 no.1
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    • pp.41-50
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    • 1985
  • To find out the differences in medical practice according to the environment of patient care and managerial situation of the medical care institutions, normal spontaneous vaginal delivery and acute appendicitis were selected, which is suitable for comparison because of their high comparability. A total of 473 cases of normal spontaneous vaginal delivery and 408 cases of acute appendicitis was sampled from the claims to Korea Medical Insurance Cooperations during January to June 1984. Complicated cases were excluded from population and sampling was restricted from 40 to 60 percentile for total charges by the type of medical care facility in order to rule out the influence originating from case mix. Important items representing type and quantity of medical care service were compared by type of facility. Major findings are as follows : 1. University hospital shows the highest in charges per case and decrease in order of general hospital, and clinic. 2. In case of normal spontaneous vaginal delivery, average length of stay shows statistically significant difference by type of facility. 3. Charge amount for each service item affected by practice pattern shows statistically significant difference mostly by type of facility. It is suggested that medical practice pattern is different by type of facility for medical services. 4. Difference in total medical expenditure by type of facility is affected more with charges for materials, consumables and drugs than with fee for service activity. 5. In administering drugs to patients, hospital and clinic show higher injection rate than university and general hospital. 6. Clinical Laboratory tests were common in order of uninalysis, hemoglobin, hematocrit, white blood cell count, urine microscopic examination in cases of normal spontaneous vaginal delivery; white blood cell count, urinalysis, hemoglobin, hematocrit, urine microscopic examination, white blood cell differential count, in cases of acute appendicitis. 7. The result for Laboratory test and Radiologic study shows extreme difference by type of facility. Test rate is lowest in clinic and increase hospital, general hospital, and university hospital in order, both in type and frequency.

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Introducing the Insurance Health Care Delivery System and Its Impact on Patients Distribution of Medical Service Organizations (보험진료체계 개편이 의료기관 종별 환자분포에 미친 영향 분석 -3차 의료기관, 종합병원, 병원, 의원을 중심으로-)

  • 공방환;한동운;장원기;강선희;문옥륜
    • Health Policy and Management
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    • v.5 no.1
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    • pp.31-58
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    • 1995
  • The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.

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Effects of Delivery Nursing Care using Essential Oils on Delivery Stress Response, Anxiety during Labor, and Postpartum Status Anxiety (에센셜 오일을 적용한 분만간호가 초산부의 분만 스트레스 반응, 분만 중 불안 및 산후 상태불안에 미치는 영향)

  • Hur Myung-Haeng;Cheong NamYoun;Yun HyeSung;Lee MiKyoung;Song Youngshin
    • Journal of Korean Academy of Nursing
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    • v.35 no.7
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    • pp.1277-1284
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    • 2005
  • Objectives: This study was designed to investigate the effect of delivery nursing care using essential oils on labor stress response, labor anxiety and postpartum status anxiety for primipara. Methods: This study used nonequivalent control group pretest-posttest design. The subjects of this experiment consisted of forty eight primipara with single gestation, full term, & uncomplicated pregnancies. Twenty four primipra were in the experimental and control group each. Their mean age was 27.9 years old, their mean gestation period 279.9 days. As a treatment, delivery nursing care using essential oils was applied by nurses. Data collected epinephrine, norepinephrine, anxiety during labor. In the 24 hours after birth, the data for the postpartum mother's status anxiety was collected. Data was analyzed by t-test, repeated measures ANOVA, Mann-Whitney U test, & Wilcoxon signed ranks test with SPSS Program. Results : Plasma epinephrine, norepinephrine were significantly low in the experimental group (P=0.001, P=0.033, respectively). There was no significant difference between the two groups in anxiety during labor and postpartum mother's status anxiety. Conclusion : These findings indicate that delivery nursing care using essential oils could be effective in decreasing plasma epinephrine, norepinephrine. But, that could not be verified in decreasing mother's anxiety.

A Study on Transdermal Drug Delivery System with Microneedle System in the Field of Skin Care (마이크로니들을 이용한 경피약물전달의 피부 미용학적 접근)

  • Kim, Sung-Jun
    • KSBB Journal
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    • v.26 no.4
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    • pp.277-282
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    • 2011
  • The penetration of outside material into skin is not easy. It is since the skin, which is a very hard barrier, protects the body against outside chemical and physical stimulation. Microneedle system which can help improve drug penetration into skin is advancing variously in transdermal drug delivery system (TDDS) in the field of skin care. After inserting microneedle into skin by using electrical or artificial forces, it makes microhole and drug penetration easily and induces natural skin rejuvenation. Diffusion and penetration of drug by optical and electrical force of microneedle is better for fast and effective TDDS. This is more developed than the traditional method such as the manual stamp, roller, and meso gun. The drug absorbed into dermal layer by microneedle helps revive and repair damaged skin. In the future, utilization of microneedle for skin care will progress constantly because of its human-friendly biodegradable materials and the development of the no pain microneedle.

호스피스 전달체계 모형

  • Choe, Hwa-Suk
    • Korean Journal of Hospice Care
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    • v.1 no.1
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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The Effects of Maternal Health Care Program on Depression, Maternal Role Self-confidence and Delivery Self-efficacy in Pregnant Women (모성건강관리프로그램이 임부의 우울, 모성역할자신감, 분만자신감에 미치는 효과)

  • Kim, Youn Sil;Lee, Yun Jeong;Park, Gyu Hee
    • Journal of East-West Nursing Research
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    • v.23 no.2
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    • pp.134-141
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    • 2017
  • Purpose: The purpose of this study was to investigate the effects of the maternal health care program on pregnant women's depression, maternal role self-confidence and delivery self-efficacy in a public health center. Methods: This study used a non-equivalent control group quasi-experiment design attempted to verify the effectiveness of maternal health care program. In the experimental group (39 participants), maternal health care program was applied for 120 minutes for 8 weeks, and the control group (40 participants) was provided with a booklet for maternal health care. Data collection was conducted from September 20, 2015 to November 30, 2015. Data were analyzed using ${\chi}^2-test$, Fisher's exact test and t-test. Results: The maternal health care program showed a significant effect on maternal role self-confidence and delivery self-efficacy compared to control group. Conclusion: The maternal health care program conducted at the public health center was found to be effective in improving maternal role self-confidence and delivery self-efficacy. Further development of a program to mediate the depression of the expectant mothers is needed.

Nursing Delivery System Improvement Plan in A Hospital (간호전달 체계 개선 방안 - 일 병동을 중심으로 -)

  • Lee, Jin-Hi;Lee, Sung-Ae;Ham, Yong-Hee;Yang, Myong-Ju;Kim, Ok-Sohn
    • Quality Improvement in Health Care
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    • v.3 no.2
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    • pp.52-59
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    • 1997
  • Background : In many Nursing Delivery System, Nursing Department at D Hospital had used to traditional nursing practice model what is called functional activities based system. It has a lot of merit that carried out specialized and rapid works but tend to ignore indivisual professional responsibility and task-based work assignments. In addition this system showed high turnover rates due to heavy workload, timesum of handing over duties, lack of support from peers and interstaff communication. So we performed conversion of Nursing Delivery System to My Patients Nursing Care System for providing comprehensive nursing to patient and reducing turnover rates and increasing job satisfaction to nurse. Method : 1. 1st step(96.4.9): Detected the problem of Nursing delivery System and estabilished improving planning 2. 2nd step(96.4.26): Visited other hospital on job training 3. 3th step(96.4.29): Discussed to premonitoring problem after conversion Nursing Delivery System and prepared structure 4. 4th step(96.5.6): My Patients Nursing Care System practical application 5. 5th step(96.7.20): Held complementary meeting 6. 6th step(96. 7): The other ward application 7. 7th step(96. 10): Extended application to whole wards Results: 1. Workload: (1) reduction(55.6%) (2) addition(44.4%) 2. Strong points after conversion: (1) decreased timesum of handing overduties (35.2%) (2) increased responsibility(33%) (3) broaden nurse's outlook to duties(14.8%) 3. Shortcoming after conversion: (1) understanding difficulties except my patient(57.8%) (2) weak teamwork(23.3%) (3) intensive stress to low grade nurse(12.2%) 4. Effective complemental way: (1) manpower(76.7%) (2) conversion of though (8.9%) (3) education(14.4%) 5. Patient's satisfaction: (1) satisfaction(64%) (2) no effect(36%) 6. Physician and peer's satisfaction: (1) satisfaction(12.5%) (2) dissatisfaction(21.6%) (3) no interest(44.3%) 7. Nurse's satisfaction: (1) satisfaction(74.7%) (2) dissatisfaction(5.5%) (3) unknown(20.5%) 8. Want to continued: (1) want(76.4%) (2) try to any other system(18%) Conclusion : Even though Nursing Delivery System conversion still has many problem, we gained more merits than traditional nursing delivery system. So we suggest that My Patients Nursing Care System should be encouraged for comprehensive nursing care and satisfaction to nurses.

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