• 제목/요약/키워드: Health Care S System

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주기적인 생리변수 측정과 전자건강설문을 이용한 재택건강관리서비스 (Home Health Care Service Using Routine Vital Sign Checkup and Electronic Health Questionnaires)

  • 박승훈;우응제;이광호;김종철
    • 대한의용생체공학회:의공학회지
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    • 제22권5호
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    • pp.469-477
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    • 2001
  • 본 논문은 가정에 있는 만성질환자, 퇴원한 환자 및 자신의 건강을 염려하는 정상인 등을 대상으로 매일 측정한 심전도. 혈압. 혈중 산소 포화농도 등과 같은 생리변수와 건강 설문에 대한 응답을 분석하여 건강상태를 지속적으로 파악하고, 비정상적인 상태가 발견될 경우에는 의사가 정확히 확인하여 필요한 조치를 조언하는 재택건강관리서비스에 대해서 기술하고 있다 재택건강관리서비스를 위해서 가입자는 재택건강관리단말기와 인터넷에 연결된 PC를 가정에 구비하여야 한다. 관제센터는 의사와 가입자의 기본정보와 가입자의 건강정보를 저장하기 위한 데이터베이스 시스템, 생체신호와 건강설문을 분석하여 현재상태의 비정상여부를 판단하는 건강상태자동평가시스템, 가입자와 의사들이 웹 브라우저를 사용하여 원하는 건강정보를 데이터베이스에서 검색, 조회하고. 그 내용을 수정. 편집하여 저장할 수 있는 웹 기반 건강정보관리시스템이 필요하다. 또한, 공중전화망 및 무선통신망을 이용한 음성 및 문자 전송과 인터넷을 이용한 전자우편에 의해 의사의 소견을 가입자에게 전달하는 통합 메시징 시스템 (UMS). 종합검진센터에서 의사가 검사결과와 문진 결과를 입력하기 위한 정보입력 PC. 병원에서 의사가 가입자의 정보를 조회하거나 정밀진단결과를 입력하기 위한 인터넷 PC 등이 설치되어야 한다. 일반에게 이러한 서비스를 널리 보급하기 위해서는, 생리변수들의 무구속 및 무자각 측정기술과 지능적인 건강평가 알고리즘의 개발에 대한 연구가 계속 수행되어야 할 것이다.

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싱가포르 보건의료체계의 약사 양성교육과 약사 직능에 대한 체계적 고찰 (A Systematic Review on the Vocational Pharmacy Education and Pharmacists' Role in the Singapore's Healthcare System)

  • 권누리;조은
    • 한국임상약학회지
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    • 제25권3호
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    • pp.187-199
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    • 2015
  • Background: Singapore has the stable healthcare system with utilizing pharmacist manpower in proper positions by demand of populations' health among Asian countries. Objective: This study aims to systematically review (1) the pharmacists' role and (2) the pharmacy education system of Singapore in comparison with Korea. Method: We searched for information about academic, medical and governmental institutions related to professional pharmacists' practice in Singapore by primarily using database such as DBpia, KISS, Google Scholar and ProQuest and the official website of the Singapore Ministry of Health. We contacted and arranged the visit schedules with National University of Singapore, National Health Group's polyclinics, Agency for Integrated Care, National University Hospital, and community chain pharmacies. During onsite visits, we interviewed pharmacists working in each institution and obtained additional documents and materials relevant to this manuscript work. Results: To become a registered pharmacist in Singapore, the pharmacy curriculum requires four full-time academic years and six additional months allotted for pre-registration training. Pharm.D. course is offered for pharmacy graduate students with additional two full-time years of study. Team teaching and inter professional education program seem the most significant method in pharmacy education. Pharmacists working at hospitals, polyclinics, and community pharmacies in Singapore take broader roles and offer more cognitive services such as smoking cessation program and medication reconciliation. Especially, pharmacists in Agency for Integrated Care fill the role of primary care providers for the continuing care of the community through the governmental support toward the patients-centered integrated care. Conclusion: Singaporean pharmacists take significant and active roles in collaboration with other healthcare providers. Efforts such as interprofessional pharmacy education and governmental endorsement of the systematic and interactive care between pharmacists and other medical providers in Singapore are needed to be urgently applied to Korea healthcare system for the promotion of population health.

치료의료계의 현안과 정책과제; 의료전달체계 확립과 전문의 진료 영역 명확화를 위한 의료법 개정 추진 방향 (Standing Issues and Policy Tasks of the Korean Dental Community; The improvement of the dental specialist program)

  • 이수구
    • 대한치과의사협회지
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    • 제48권2호
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    • pp.91-94
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    • 2010
  • Regarding the improvement of the dental specialist program, two related issues were reviewed extensively: (a) bill amending portions of the Medical Service Act as proposed by national assemblywomen Choi Yeong-hui (Democratic Party) and Chung Mi-gyeong (Grand National Party), and; (b) Plans to supplement the submitted bill. Although the existing bill's prospects in the assembly are unclear at this point, both the existing and planned supplementary bills zero in on two points: (a) specialists must focus on providing care only in their respective expertise, and; (b) a distinction between the roles played by the primary, secondary, and tertiary medical institutions must be made to help establish clearly the country's overall health care system. In addition, proposals were made for medical license renewal among specialists so that professionals can offer better health care to customers.

일본의 노인보건시설에 대한 연구 (Study of the Geriatric Health Care Facility in Japan)

  • 조유향
    • 보건교육건강증진학회지
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    • 제9권1호
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    • pp.79-87
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    • 1992
  • The objective of the present study is to review of the system, type of care and utility of the Geriatric Health Care Facility(GHCF) in Japan. Geriatric Health Care Facilities in Japan were started with subsidies from the Ministry of Health and Welfare in 1987 to encourage return of the elderly from hospitals to their homes rather than other destinations such as nursing homes or hospitals. Concerning to the type of care, there is the difference between GHCF and other geriatric care facilities(i.e., geriatric hospital and nursing home). GHCF provides both medical and nursing care. The following services are available for the GHCF's user's. As institutional care services, rehabilitation training, ADL exercise, nursing care and management of medicine, are available. For the out-patients, supplying meals, taking a bath, and rehabilitation services, are also available. The medical treatment fee at the facilities is about US $ 1,500 per month. Expenses for meals, daily necessities, shall be borne by the recipient, Those expenses are about US $ 360 per month. In anticipation of the coming of the aging society, the Goverment must be formulated consecutively several vital policies of measures, especially GHCF, for the elderly in the future few years.

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

  • 김혜숙;최연순;전은미
    • 대한간호학회지
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    • 제24권4호
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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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건강전문가의 산후관리 인식에 대한 연구 (A Study on the Health Professional's Perception of Postpartal care)

  • 장문희;유은광
    • 여성건강간호학회지
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    • 제5권3호
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    • pp.313-326
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    • 1999
  • This study sought to find out the level of perception of postpartal care and the meaning and opinion of traditional postpartal care (Sanhujori) from health professional. The subjects were 188 health professionals who work at University hospital, clinics, Oriented clinics, and midwifery clinics in Seoul and Chung-Buk, Korea. Data were collected from 8th April, 1999 to 6th May, 1999. The data were analyzed through the SPSS program by use of frequency, percentage, t-test, ANOVA and Scheffe test as a post hoc contrast, $x^2$-test, and stepwise multiple regression. The results of the study were as follows: mean age of the subject was 33.0 years and female was 58.0%. Occupation of the subject was nurse 28.7%, doctor 22.3%, midwife 21.3 Korean Oriental doctor 27.0%. Mean period of career was 7.6 years and the subject who experienced Sanhujori was 54.3%. The subject who did not know 6 principles of Sanhujori was 73.9%. In the opinion on traditional Sanhujori method 68.1% of respondents expressed that Sanhujori is scientific postpartal care which fits Korean people's physical constitution and culture. On the opinion of effective postpartal care in 97.9% of respondents expressed that it is to in hospital postpartal care and traditional Sanhujori perform it according to Korean culture constitution. On the opinion of Sanhujori, 96.6% of respondents expressed that it is necessary to understand Sanhujori with consideration which was adapted to Oriental culture and to verify it through continual study. On the opinion of the effect of the level of performance of Sanhujori upon women's health life, 43.2% of respondents expressed that the level of performance of Sanhujori has great effect on women's general health, including postpartal recovery, Sanhujori prevention, and so on. On the opinion of Sanhujori of women who undergo Caesarean operation, 57.7% of respondents expressed that women who undergo Caesarean operation perform Sanhujori with more attention. On the opinion of Sanhujori center (sanhujorwon), 56.3% of respondents expressed that the center is necessary for women's health and health professional are required to manage the center scientifically. On considering the level of importance of post care according to occupation, midwife showed highest level of importance of traditional Sanhujori doctor the lowest level. Midwife showed the hi level of importance of postpartal care and K Oriental doctor showed the lowest level of importance of women's postpartal care. On considering the relationship between the level of importance of postpartal care and general characteristics, sex, career, clinical department and whether they know 6 principles of Sanhujori or not were statistically significant at the level of 5%. In the stepwise multiple regression analysis, the main influencing variables on the level of importance of postpartal care were occupation, sex, and clinical department. In conclusion, this finding confirmed that professionals were considering the traditional Sa importantly for women's health. Above all things necessary for health professional to integrate concept of traditional Sanhujori into practical nu intervention program, to apply it to profes practices in order to reestablish effective integrative postpartal caring system, and to Sanhujori scientific through performing continual research.

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보건 진료원 제도 운영 평가에 관한 연구 -우리나라 1차 보건의료 제도 방향 재설정을 위하여 - (A Review of the Operation Community Health Practitioner System as a Reorientation of Primary Health Care)

  • 홍여신;이인숙
    • 대한간호학회지
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    • 제24권4호
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    • pp.568-583
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    • 1994
  • In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.

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한국과 독일 방문요양의 등급별 급여 비교 연구 (A Comparative Study on the Care Services According to Care Levels in the Korean and German Home Care System)

  • 박종덕
    • 가정간호학회지
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    • 제23권2호
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    • pp.243-252
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    • 2016
  • Purpose: This study aims to classify multiple forms of home care services from a service user's perspective. By comparing the German system to the Korean one, this study seeks to find better ways of enhancing client-centered care. Methods: The data of 121 home care users were collected from six home care centers that had under the management of nursing managers for more than five years. The researcher used a German instrument to estimate the level of care. Results: High correlation was found between German and Korean assessment criteria (r=0.81, p<.001). However, compared to their German counterparts, Korean home care providers allocated more time towards provision of domestic help per daily visit. German home care providers allocated more time towards services relating to provision of support for physical activities, including personal hygiene. It was confirmed that the level of care in Korea does not correlate with either the categories of home care services and duration. Conclusion: Therefore, care services should be offered according to long-term care needs. This study suggests a need for systematic care aimed at strengthening the client's autonomy which should be properly planned, implemented, and managed.

u-아동 신체 & 정선 건강 Wellness Care Service 설계 및 구현 (u-Children's Physical and Mental Health Wellness Care Service Design and Implementation)

  • 신유민;박범
    • 산업경영시스템학회지
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    • 제33권4호
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    • pp.28-37
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    • 2010
  • In this study, services for promoting health were provided to kindergarten children. As u-Health services for children, services centered of positioning of children are provided. However, since problems related with obesity and mental health are increasing day by day due to westernized eating habits, the necessity of physical and mental health care for children is on the rise. Considering this state, in this study, experiments of u-Health services under the concept of wellness were conducted on kindergarten children. For physical health, the children's obesity was controlled and for mental health, services of diagnosing hyperactivity disorder which is a sub symptom of ADHD were provided. Based on the results, it could be identified that parents' satisfaction and children's health conditions were improved.

지역사회중심 가정간호사업 개발 및 평가 (Development & Evaluation of Community-Based Home Care Nursing Service Program)

  • 이원희;김조자;강규숙;오의금;박희옥;조원정
    • 지역사회간호학회지
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    • 제15권2호
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    • pp.209-217
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    • 2004
  • Purpose: The purpose of this study was to construct the structure, process and outcome of community-based home care nursing service and to examine their validity. Method: There were two steps. The first step was developing the structure and process of community-based home care and the second was evaluating the outcome of community-based home care. Home care services were provided to 25 clients who had health problems. Data on these clients were analyzed. Result: According to Albrecht Model, in the developed structure and process of community-based home care, structure contained facility's philosophy, organization, delivery system, steering committee, office, equipments, medical instruments, the home care nurse and client of home care nursing. Process contained classification of client. nursing diagnosis and nursing intervention. The majority of clients were men (56%). The service was used mostly by people aged over 50 (82%). The most frequent nursing diagnoses were altered urinary elimination (23.2%). impaired skin integrity (21.8%) and risk for infection (17.6%). Nursing interventions included wound care (16.7%), tube care (15.1%) and catheter care (14.5%). Conclusion: Several strategies are suggested from this study: first, activate a referral system within the national health care system: second, increase public information on home care nursing: third, develop home care nursing services for elderly people: and fourth, construct a cooperation system between home care services and social welfare services.

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