• Title/Summary/Keyword: Healthcare Delivery System

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Analysis of the Contents of Visiting Nursing Articles on Domestic Portal Sites Using Topic Modeling: Focusing on the Comparison Before and After Coronavirus Disease (토픽 모델링을 이용한 국내 포털사이트 방문간호 기사 내용 분석: 코비드-19 이전과 이후 비교를 중심으로)

  • Lim, Ji Young;Lee, Mi Jin;Kim, Geun Myun;Lee, Ok kyun
    • Journal of Home Health Care Nursing
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    • v.30 no.2
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    • pp.141-154
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    • 2023
  • Purpose: This study aimed to explore the social perception of visiting nursing before and after coronavirus disease (COVID-19). Methods: This survey-based study used online big data for comparative analysis by classifying the keywords related to visiting nursing searched on domestic portal sites before and after COVID-19. Results: According to the results of analyzing the Intertopic Distance Map based on Latent Dirichlet Allocation in this study, four topics were extracted, two each before and after COVID-19. The first topic before the COVID-19 period was termed "the expansion of visiting nursing subjects and services visiting nursing," while the second was termed "visiting nursing," which is related to customized welfare. The first topic after the COVID-19 period was termed "the suspension and resumption of visiting nursing services," while the second was "the development of a non-face-to-face home visit healthcare system". Conclusion: The results of this study can be used as useful reference data to contribute to future medical service delivery system reform policies starting at the end of COVID-19 and the revitalization of community care for visiting nursing.

Standardization Plan for Clinical Practice of the Physical Therapy Education in South Korea (대한민국 물리치료 임상실습 표준화 방안)

  • Ki-Song Kim;Yeon-Sub Lee;Tae-Sik Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.3
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    • pp.93-100
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    • 2024
  • Purpose : This study aims to review the physical therapy training programs in the United States, Canada, Taiwan, and Japan, and propose standardization plan for clinical practice in physical therapy education to advance the development of physical therapy education in South Korea. Methods : This study investigates the clinical practice standards in advanced countries such as the United States and Canada, and refers to the clinical practice standards in Taiwan and Japan, which are members of the association of world phyisotherapy and have economic, cultural, educational, and healthcare delivery systems, as well as legal systems, similar to those of South Korea. Results : In the United States, physical therapy education programs allocate an average of 22 weeks and 880 hours for clinical practice. Foreign-trained physical therapists who wish to take the licensure exam in the United States must have their educational programs reviewed and recognized as having completed at least 1,000 hours of clinical practice. In Canada, physical therapy education programs allocate an average of 31 weeks and 1,240 hours for clinical practice. Taiwan allocates over 1,440 hours of clinical practice in its educational programs, while Japan requires 800 hours of clinical practice as a legal prerequisite for the licensure exam. Conclusion : Based on the results of this study, the following standardization plan for clinical practice of the physical therapy education in South Korea are proposed. First, a minimum of 16 weeks and 640 hours of clinical practice is necessary to produce competent physical therapists. Second, university-based basic practical training should be at least 440 hours, with the introduction of a standardized accreditation system and unification of the four-year academic system. Third, the qualifications of physical therapists who supervise clinical practice in medical institutions should be clearly defined in the curriculum, and the standards for clinical practice instructors need to be expanded.

Convergence Research on Periodic Changes in the Quality Assessment of Surgical Prophylactic Antibiotics (수술 예방항생제 적정성 평가의 주기별 융합 변화 연구)

  • Yang, Sae-Yie;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.14 no.6
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    • pp.325-333
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    • 2016
  • This study was conducted to provide the base line for the use of prophylactic antibiotics and the standard of antibiotic use and the evaluation based on analysis of current use, quality assessment and periodic changes of prophylactic antibiotics in a university hospital. We chose the year 2008, 2009, 2010, 2012, and 2014 as the study periods since the primary evaluation on the first year of implementation in 2007. For this study, healthcare benefit quality assessment data from the Health Insurance Review and Assessment Service was used. We analyzed the differences each year of treatment period; one category for initial treatment timing, three categories for selecting antibiotics, and two categories for the length of treatment from multiple evaluation indices of gastric surgeries, colorectal surgeries, and cholecystectomy. The analysis revealed the followings: Regarding length of antibiotics treatment, total days of treatment decreased down to 1.5, 1.5, and 0.6 days in the year 2014, from 13.5, 12.8, and 6.9 days in the year 2007, for gastric surgeries, colorectal surgeries, and cholecystectomy. Based on these outcomes, the efforts to devise efficient delivery and distribution of the recommendations or indices which medical staff could adhere for quality improvement of the prophylactic antibiotics would be necessary. Also implementing monitoring system to help the hospitals to acknowledge their own faults may be helpful.

Issue Analysis on the Deregulation of Telemedicine in the Digital Convergence Era (디지털 융복합시대에 원격의료 규제 완화에 관한 쟁점 분석)

  • Kim, Jin-Suk;Oh, Su-Hyun
    • Journal of Digital Convergence
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    • v.18 no.12
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    • pp.445-457
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    • 2020
  • The purpose of this study is to analyze various issues that may arise from the recent deregulation of telemedicine implemented by the government, propose initiative preparations for the implementation of telemedicine policies, and suggest implications for the basic conditions and direction of the deregulation of telemedicine. Recently, deregulation policy cases in telemedicine include that designation of a special zone for regulatory freedom in Gangwon Province, allowing physician-patient telemedicine and telephone counseling and prescription cases in the COVID-19 crisis. There are four main issues that could arise with the deregulation of telemedicine: safety, effectiveness, differences in access to health care and the economic industry, and legal responsibility. As a initiative preparation, this study proposed a pilot project for telemedicine and enhanced support for face-to-face care complementary tools, vitalizing remote co-operation, policy model that do not disrupt the medical delivery system, and legal maintenance. In conclusion, as a suggestion of basic premise and direction in the implementation of telemedicine deregulation, the implementation of initiative measures to address issues concerning telemedicine, the review and regulation of conditions to be considered in the implementation of telemedicine, and the establishment of a close communication and cooperative sturcture with medical providers.

Periodontitis among poor rural Indian mothers increases the risk of low birth weight babies: a hospital-based case control study

  • Jacob, Pulikottil Shaju;Nath, Sonia
    • Journal of Periodontal and Implant Science
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    • v.44 no.2
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    • pp.85-93
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    • 2014
  • Purpose: Low birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies. Methods: A hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ${\geq}2,500g$. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth. Results: LBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2). Conclusions: Periodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.

The Effect of CYP Polymorphism on Resistance against Praziquantel in Clonorchis Sinensis-infected Patients

  • Kim, Chung-Hyeon;Choi, Min-Ho;Chae, Jong-Il;Shin, Eun-Hee;Hong, Sung-Tae
    • Molecular & Cellular Toxicology
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    • v.3 no.3
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    • pp.195-197
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    • 2007
  • Currently praziquantel is used for treatment of not only clonorchiasis but also other trematodes and cestodes. But cure rate of praziquantel is just 60-80% for most trematodes. It needs for the treatment-failed patients to have more drugs. The cause of failure of treatment is not studied. We just know that the blood level of praziquantel is severely different among the people. We guess that this factor may influence the results of treatment. In an endemic area of human clonorchiasis in Heilongjiang Providence, China, 78 subjects were selected for the study. Three doses of 25 mg/kg (total 75 mg/kg) of praziquantel were administered to 78 clonorchiasis patients. After three weeks of treatment, stool examination was undertaken once again to confirm the cured and uncured subjects. To analyze SNP (single nucleotide polymorphism) of CYP3A5 PS2-1, CYP3A5 PS2-2, and CYP3A5*6, PCR method was done with specifically designed primers. The mutation rates of all sites were not significant statistically. The number of subjects was too small, so we need more subjects and other delivery proteins of bile ducts (ex. MRP etc.) were also considered for effects of praziquantel. We analyzed, for the first time, the entire CYP3A5 gene in a French population, using a polymerase chain reaction- single strand conformational polymorphism (PCR-SSCP) strategy.

Utilization of Hospitals Located Outside Patients' Residential Areas among Those with Acute Cerebral Infarction (급성뇌경색증 환자의 타지역 의료기관 이용현황 및 관련 특성 연구)

  • Lee, Sae Young;Kim, Stella Jung-Hyun;Park, Keun Young;Kim, Ji Man;Kim, Han-Joon;Lee, Changwoo;Shin, Euichul
    • Health Policy and Management
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    • v.28 no.1
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    • pp.48-52
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    • 2018
  • Background: The current study evaluated the hospital utilization and characteristics of patients who received health care services for acute cerebral infarction outside their own residential area. Methods: Using the 2014 national patient survey data, information on 2,982 patients diagnosed with acute cerebral infarction through emergency department were retrieved for the analyses. Multiple logistic regression was performed to investigate the characteristics associated with using hospitals outside residential area among patients diagnosed with acute cerebral infarction. Results: Fifteen point nine percent of patients admitted for acute cerebral infarction utilized hospitals outside their residential area. Patients residing in a province were 7.7 times more likely to utilize hospitals located outside their residential areas compared to those living in Seoul metropolitan city. Patients living in Gangwon and Jeolla were 0.26 times and 0.48 times more likely to go to hospitals in different geographical areas. Also, patients within the age group of 80 years and over were 0.65 times less likely to be admitted to hospitals outside their residential area compared to those in their 40s-50s. Conclusion: The use of hospitals outside patient's residential area is shown to be substantial, given that the acute cerebral infarction requires immediate recognition and treatment. The findings on the geographical differences in the hospital utilization suggest further investigation.

Patients' and General Practitioners' Views About Preventive Care in Family Medicine in Switzerland: A Cross-sectional Study

  • Cohidon, Christine;Imhof, Fabienne;Bovy, Laure;Birrer, Priska;Cornuz, Jacques;Senn, Nicolas
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.5
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    • pp.323-332
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    • 2019
  • Objectives: The aim of this study was to describe general practitioners (GPs)' opinions and practices of preventive care and patients' opinions, attitudes, and behaviors towards prevention. Methods: The data stemmed from a cross-sectional national survey on prevention conducted in Switzerland from 2015 to 2016. In total, 170 randomly drawn GPs and 1154 of their patients participated. The GPs answered an online questionnaire and the patients answered a questionnaire administrated by fieldworkers present at their practices. Results: Both patients and GPs agreed that delivering preventive care is the dedicated role of a GP. It appeared that beyond classical topics of prevention such as cardiovascular risk factors, other prevention areas (e.g., cannabis consumption, immunization, occupational risks) were scarcely covered by GPs and reported as little-known by patients. In addition, GPs seemed to use a selective approach to prevention, responding to the clinical context, rather than a systematic approach to health promotion. The results also highlight possibilities to improve prevention in family medicine through options such as more supportive tools and public advertising, more time and more delegated tasks and, finally, a more recognized role. Conclusions: Despite an unfavorable context of prevention within the healthcare system, preventive care in family medicine is reasonably good in Switzerland. However, some limitations appear regarding the topics and the circumstances of preventive care delivery. A global effort is needed to implement necessary changes, and the responsibility should be broadened to other stakeholders.

The Impact of Time-to-Treatment for Outcome in Cancer Patients, and Its Differences by Region and Time Trend (암환자의 진단-치료 소요기간에 따른 생존분석과 지역사회별 격차 및 시계열적 추이)

  • Kim, Woorim;Han, Kyu-Tae
    • Health Policy and Management
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    • v.31 no.1
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    • pp.91-99
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    • 2021
  • Background: The Korean government introduced National Cancer Control Program and strengthening national health insurance coverage for cancer patients. Although many positive effects have been observed, there are also many concerns about cancer management such as patient concentration or time-to-treatment. Thus, we investigated the association between the time-to-treatment and survival of cancer patients, and compared regional differences by time trend. Methods: The data used in this study were national health insurance claims data that included patients diagnosed with lung cancer and received surgical treatment between 2005 and 2015. We conducted survival analysis with Cox proportional hazard model for the association between time-to-treatment and survival in lung cancer. Additionally, we compared the regional differences for time-to-treatment by time trend. Results: A total of 842 lung cancer patients were included, and 52.3% of lung cancer patients received surgical treatment within 30 days. Patients who received surgical treatment after 31 days had higher 5-year or 1-year mortality compared to treatment within 30 days (5-year: hazard ratio [HR], 1.566; 1-year: HR, 1.555; p<0.05). There were some regional differences for time-to-treatment, but it was generally reduced after 2010. Conclusion: Delayed surgical treatment after diagnosis can negatively affect patient outcomes in cancer treatment. To improve cancer control strategies, there are needed to analyze the healthcare delivery system for cancer care considering the severity and types of cancer.

A Preliminary Study with the Objective of Developing a Community based Postpartum Women's Follow-up Program (지역사회 중심의 산욕기 산모 추후관리 프로그램 개발을 위한 기초조사)

  • Kim Myoung Hee
    • Journal of Korean Public Health Nursing
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    • v.15 no.1
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    • pp.27-41
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    • 2001
  • The purpose of this study was to discern the level of satisfaction of postpartum care in hospitals. the level of importance of traditional postpartum care and the need for home health care for postpartum women. The study's design was to obtain data needed to develop a community-based postpartum care program and to improve the quality of nursing for postpartum care recipients. Data for the study was collected from 1 March to 31 June 2000 from 116 postpartum care recipients treated in Chung-Buk, Korea. Data analysis consisted of frequency, percentage, t-test, and ANOVA. using SPSS win program. The results the of analysis were as follows: 1) The level of satisfaction of postpartum care in the hospital (mean 1.31) was very low. The most laudable items of nursing care by category were: moderate satisfaction with 'perineal wound care' (2.04) and 'afterpain observation'(2.09). The overall level of satisfaction of postpartum care in the hospital. however, was very low. 2) Among other items of postpartum care in the hospital, 'postpartum exercise' $(25.9\%)$. 'assessment and support for postpartum depression' $(25.9\%)$, 'operation wound care for women who underwent Caesarean sections' $(24.5\%)$. and 'contraception and family planning' $(20.4\%)$ showed a need for home health care for postpartum care recipients above $20\%$. 3) The level of importance of traditional postpartum care (Sanhujori) was relatively high (mean 2.72). The importance of Sanhujori by category was as followed: 'the fourth principle: protecting the body from harmful strains' was the highest (2.88), 'the third principle: eating well', 'the first principle: invigorating the body by augmenting heat and avoiding cold', 'the second principle: resting without working', 'the fifth principle: keeping clean' and 'the sixth principle: handling with the whole heart' showed 2.85, 2.80, 2.70, 2.51 and 2.46 respectively. 4) The need for home health care with Sanhujori was very low. 5) The relationship between demographic factors and the level of satisfaction with postpartum care in the hospital was as follows: the satisfaction levels were significantly different among' delivery frequency' and 'health status' alteration after delivery'. 6) The relationship between demographic factors and the importance of the Sanhujori category was as follows: There were no significant differences in the level of importance of the first and the forth principle of Sanhujori. The level of importance of the second principle of Sanhujori was significantly different among 'income' and 'family type'. The level of importance of the third principle of Sanhujori was significantly different among 'having a boy'. The level of importance of the fifth principle of Sanhujori was significantly different among 'income' and 'feeding type'. The level of importance of the sixth principle of Sanhujori was significantly different among 'education background' and 'feeding type'. In conclusion. the findings of this study illustrate the nursing needs of postpartum care recipients. It provides a challenge to caregivers in the healthcare industry to develop a continuous postpartum care program and integrative postpartum care system that embodies the oriental and western paradigm for the promotion of women's health.

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