• 제목/요약/키워드: Health Care S System

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노인장기요양보험의 방문간호 제공기관 특성별 서비스 제공 추이 (Trends in Home-visit Nursing Care by Agencies' Characteristics under the National Long-term Care Insurance System)

  • 이정석;황라일;한은정
    • 지역사회간호학회지
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    • 제23권4호
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    • pp.415-426
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    • 2012
  • Purpose: This study aimed to investigate trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. Methods: Cochran-Mantel-Haenzel tests were conducted, using data drawn from the nationwide long-term care insurance claim database of the Korean National Health Insurance Corporation from 2009 to 2011. Results: The number of home-visit nursing care agencies has decreased continuously since 2009. There were also similar trends in the total amount of service provided by home-visit nursing care agencies, the number of recipients, the number of employees, and payments. This study showed that there were statistically significant differences in the trends in home-visit nursing care by agencies' characteristics. Despite the overall downward trend, there were some increases in the percentage of home-visit nursing care provided by agencies which were established by individuals, located in large cities, and which combined home-visit care with home-visit bathing. Conclusion: Home-visit nursing care agencies are responsible for providing community-based healthcare services. For past three years, however, they have not been utilized to their full potential. Understanding the trends in home-visit nursing care by agencies' characteristics is important to develop utilization strategies for home-visit nursing care.

가정간호실무에 적용가능한 이론적틀 (Appling Nursing Theory to Clinical Practice of Home Health Care)

  • 우선혜
    • 가정간호학회지
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    • 제11권1호
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    • pp.5-13
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    • 2004
  • The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.

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무의 농촌지역 여성노인의 건강관리 경험 (Elderly women's Health Care Experience at Doctorless Farm Willages)

  • 김영희;한영란
    • 여성건강간호학회지
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    • 제9권4호
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    • pp.467-478
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    • 2003
  • Purpose: This study investigated elderly women's health care at doctorless farm villages based on information-about the perception and management of their health. Method: Grounded theory method as mapped out by Strauss and Corbin-was used to record and transcribe open-ended interviews. The data from these interviews were analyzed. Result: We found 18 categories and 28 sub-categories. In data analysis, the core phenomenon was named "movement in pain". Causal condition as essential prerequisites were aging symptoms, bad state of health, comfortable life to live alone, longevity, deficiency of health care resources, and sub-categories of the phenomena revealed acceptance of discomfort, enduring pain, continuity of movability. Elderly women's health-related activities included enduring as it is, movement consciously, applying resources, difficult in using health medical institutions. Family support, economic level, disease condition, support system of community were influenced to their health-related activities. Consequently, the results indicated that they wanted to accept given life, expected easy death. held out remaining life. Conclusion: This study revealed that the most important factor of elderly women's health care was "movement in pain". On the basis of this study, we needed to develop diverse nursing implementation plans for maintaining and improving' movability without pain'.

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응급상황의 신속한 감지를 위한 u-Health 시스템 개발에 관한 연구 (Development of u-Health Care System for Prompt Perception of Emergencies)

  • 장동욱;선복근;손석원;한광록
    • 정보처리학회논문지B
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    • 제14B권6호
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    • pp.401-406
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    • 2007
  • 본 논문은 만성질환을 갖고 있으면서도 일상생활을 하고 있는 환자들의 응급상황을 신속히 감지하여 능동적으로 대처할 수 있게 하는 u-Health 시스템의 개발에 관하여 기술한다. 기울기 및 진동 센서, GPS, CDMA 통신 모듈 등으로 구성된 PHCH(Personal Health Care Host) 장치에 의해 환자의 위급상황이 신속히 감지되면 현재 환자가 위치한 위치정보를 병원과 보호자의 모바일 단말기로 문자 전송하여 상황에 즉각 대처할 수 있도록 한다. 특히, 시스템은 신경회로망을 이용하여 센서로부터 수신되는 신호 데이터를 분석하고 기절 또는 발작 증상과 같은 응급상황을 신속히 판단한다. 또한 환자의 응급 상황시에 GPS 데이터를 이용하여 환자의 위치를 지도에서 확인할 수 있다. 일상생환을 하면서 항상 주의가 필요한 만성질환자에게 이 시스템을 적용시킴으로써 응급 상황에 신속히 대처하여 귀중한 생명을 구할 수 있을 것으로 기대된다.

의료보험 민영화가 여성의 건강에 미치는 영향 : 칠레의 사례를 중심으로 (Lessons from Chile: The Impact of Privatization of Health Insurance on Women's Health)

  • 박윤주
    • 이베로아메리카
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    • 제13권1호
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    • pp.69-94
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    • 2011
  • Chile has been the first country in Latin America which has built a two-tiered health care system by partially privatizing the health insurance sector. Despite the intial decrease of health expenditure, more researches now show that health inequality within the Chilean health sector has been augmented with privatization of its insurance system. To explore such inequality, this article looks into the impact of privatization of health insurance on women's health. The author argues that privatization has intensified medicalization of women's body and, consequently, it worsened women's health in Chile. This article contributes to a more comprehensive understanding of market-oriented health care reform by linking it with medicalization process.

대학생의 우울증에 관한 연구 -우울 측정 척도를 이용한- (The Depression Scales and The College Students' Health Care)

  • 이광혜
    • 지역사회간호학회지
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    • 제8권1호
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    • pp.144-154
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    • 1997
  • This study is planned to gather necessary data for setting up a system on students' health care in the university. In order to obtain statistical data on the students' health care problems especially in 'depression' among the mental health problems of the students, 'The Beck Depression Inventory' by A. T. Beck and 'Zung's Self-Rating Depression Scale' by W. W. K. Zung were used for gathering numerical data of scale of depression. It is evident that we have to prepare for further medical examination and health care educations for several students. For these students, it is clear that they have problems not only in mental health but also in physical health. I have screened out the high scored students for comparison and analysis. And it disclosed that we have to build up a periodical and continuous 'Health Screening System' utilizing Health Questionnaire for both physical and mental aspects, which will bring up us the very exact result to pick out any person who has healthy problem among the enormous number of the students with handy, convenient and effective procedures but with the least expense and effort. Also it is my firm confidence that this system will be applicable for primary health care control of mass population in local community or any organization.

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보건진료소 영유아 예방접종사업(1980년~2009년) (Vaccination for Infants and Children in the Primary Health Care Posts from 1980 to 2009)

  • 손계순
    • 한국농촌간호학회지
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    • 제3권2호
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    • pp.96-103
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    • 2008
  • Purpose: The Study of vaccination for infants and children business in Primary Health Care Posts from 1980 to 2009. Method: look for national essential vaccination look for the change of vaccination by the times in Primary Health Care Posts and the rate of vaccination for infants and children by a administrative report statistics survey of a vaccine delivery system of Public health care institutions investigation about assistance details of vaccination cost in order to raise the rate of vaccination for infants and children. Results: In 1980s, there are many infants and children management object, but now there are rapidly decreasing infants and children management subject of a Primary Health Care Post because of rural exodus phenomenon of 1990's and a low birthrate of 2000's. Currently, the infants and children that registed, and managed to a Primary Health Care Post is most multi-cultural families. A multi-cultural family assistance program is provided these infants and children to the objects. Conclusions: Infant vaccination execution in Primary Health Care Posts showed to high vaccination rate because the prevention of vaccination delay or omission of the interior child who raised geographical accessibility to object sons nowadays it difficult to management of transportation of vaccine and storage management for a little shroud objects limited and management of inoculation business in quality. A main problem is as follows. There are a little vaccine transportation, trouble of proper temperature maintenance of a storage process, and having a lot of vaccine abolition as a little objects, educational training shortage of health care practitioner regarding to execute an inoculation. Therefore, vaccination business needs measures for management in quality in Primary Health Care Posts.

의료보험(醫療保險) 실시이후(實施以後) 지역주민(地域住民)의 의료기관이용행태(醫療機關利用行態) 변화(變化) 추이(推移)와 그 요인(要因)에 관한 조사연구(調査硏究) (Analysis on the trends and causes of inhabitant's behavioral changes in medical institutions's utilization after enforcement of regional medical insurance. (pilot-project area of regional medical insurance; mainly Kun-wi and Kwang-hwa county))

  • 박정연
    • 한국보건간호학회지
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    • 제3권2호
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    • pp.47-76
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    • 1989
  • The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

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OECD 국가의 보건의료개혁 : 역사적 전망과 정책적 과제 (Health Care Reform in OECD Countries : A Comparative Policy Analysis)

  • 이종찬
    • 보건행정학회지
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    • 제6권1호
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    • pp.1-28
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    • 1996
  • The paper analyzes OECD health systems from the perspective of historical institutionalism. Criticizing the dependence of Korea's national health program on Pacific countries such as Japan and the U.S., it suggests that European experiences of national health programs can be a model of the Korean health system in the future. Based on an inquiry into Italian and British cases of national health systems, the author emphasizes (1) the role of local governemts in national health programs, and (2) the integration of a national health program with public health programs.

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