• The Korean Nurse
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• v.29 no.2
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• pp.48-65
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• 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.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.434-441
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• 2010

Background: Chronic obstructive pulmonary disease (COPD) is a major health problem resulting in significant burden for patients and families. However, family caregivers' burden has not been well recognized. The objectives of this study were to evaluate the level of caregivers' burden and to explore the related factors based on family, patient, and social support factors. Methods: A face-to-face interview with 86 family caregivers who had been taking care of COPD patients was conducted. The participants answered a self-administered questionnaire. The questionnaire included the level of family caregivers' burden, health status and the relationship within the family, functional limitation of patients perceived by family caregivers and the social support. Results: The level of caregivers' burden among participants was considerably high. Risk factors for caregivers' burden included low educational level of family caregivers, low family income, hours of caregiving, and functional limitation of the patients. Protective factors for caregivers' burden were good relationship within the family and support from other family members or friends. Conclusion: It is proved that family caregivers are facing significant burden in taking care of COPD patients. To reduce family caregivers' burden, it is necessary to address socioeconomic status of the family and to provide various community resources including financial support and nursing services.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.586-589
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• 2006

Deep circumflex iliac artery (DCIA) flap can be harvested as a composite free flap and is often used to adequately reconstruct wide mandibular defects. However, the harvesting of this DCIA flap can result in severe osseous defect of the donor site causing a morphologic defect in the iliac crest. To reconstruct this defect of the iliac donor site, several innovative techniques using bioactive ceramic spacers, autogenous rib bone, polylactic acid mesh, or titanium plates have been introduced. Nonetheless, these methods have not been widely used due to high cost, secondary donor site morbidity, difficulty of use, and postoperative dissatisfaction. We used two titanium plates to reconstruct the donor iliac site defect at the harvesting time of primary DCIA flap surgery in the 30-year old female with an ameloblastoma in the left mandible. Postoperatively, both iliac sites were relatively balanced and there were few complications. At the 2 years follow-up, there were no specific abnormal radiographic findings and the patient was very satisfied with her esthetic iliac contouring. In our report, we evaluate the effect of two titanium plates on the reconstruction of the iliac donor site in the aspects of esthetics and usefulness. This technique has many advantages, such as reduced cost, simplicity, decreased postoperative pain or discomfort, and improved bilateral balance of both anterior iliac crest contours, especially in young female patients.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.325-333
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• 1995

Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.

• International journal of advanced smart convergence
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• v.9 no.1
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• pp.185-192
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• 2020

The number of dementia patients in Korea is expected to increase to 3.30 million in 2050, and the cost of dementia management will increase sharply to KRW 106.5 trillion of GDP. In August 2017, the Moon Jae-in government announced the 'Dementia National Responsibility System' through a five-year plan for government operation and expanded the Dementia Peace Center nationwide. However, for this, strategic dementia-related technology development strategies should be established and given the role of government and the role of the private sector. Therefore, in order to derive the corresponding strategy, this study developed the government's 'dementia' response technology development strategy through the situation analysis from the political, economic, social, and technological perspective and the environmental (PEST) analysis of the strengths, weaknesses, opportunities, and threats (SWOT). As a result, the direction of technology development in the dementia-related medical device market is expected to become a trend of developing dementia self-measurement by developing low-cost and high-efficiency diagnostic technology products. It has been shown that the development of various products for consumers should begin. As a result, the dementia market approach strategy should be premised, the related technical support and legal restrictions should be minimized, and the education of related experts should be strengthened to solve the government's development of dementia technology and the social problems of dementia. In addition, by developing joint projects with major companies around the world and actively participating in the technology platform, it is important to naturally build up skills accumulation for the development of dementia technology and competence skills of dementia technology experts in the long term.

• Journal of Acupuncture Research
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• v.27 no.2
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• pp.43-49
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• 2010

Objectives : Among young generation, the prevalence of spinal disorders is known to be increasing. This study aimed to analyze the clinical data of spinal disorder in young ages in Korea. Methods : Number of patient, kinds of disorder, and medical cost were analyzed for patients(7~18 years) underwent spinal disorders using computerized database of Health Insurance Review and Assessment Service(HIRAS) from 2004 to 2008. We included dorsopathies as spinal disorder according to Korean Classification of Diseases(KCD) and excluded spinal disorder caused by trauma. We compared the data of traditional Korean medicine treatment with that of western medical care. Results : 4.8% of the children and adolescents had medical treatment with spinal disorder in 2008. The claim number and medical cost for both traditional Korean medicine and western medicine treatment are increasing 1.8 and 1.3 times respectively over 5 years. Total medical spent of western clinic was 2.1 times than those of traditional Korean clinic. The most common spinal disorder was dorsalgia(31.8%) and scoliosis(13.5%) in western clinics while back pain(29.0%) and neck pain(10.8%) in oriental clinic. Conclusions : We first reported the clinical tendency of spinal disorder in Korean children adolescents from 2004 to 2008. This study will support the development of a strategy for traditional Korean medicine-based prevention or treatment of spinal disorders in young generation.

• Journal of East-West Nursing Research
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• v.5 no.1
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• pp.114-119
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• 2000

This paper reviews the curriculums on the nursing in oriental medicine currently provided by Korean nursing education institutes. As of October 2000, 14 of 48 four-year-system and 40 of 65 three-years system nursing schools provide the various academic courses and programs titled with the nursing care in oriental medicine. Depending on schools, the credit assigned to these courses and programs vary widely ranged from 1 to 8 units. Even in some schools the courses are offered not as a regular credit course but as a part of other courses on time sharing base. It is absolutely insufficient efforts in promoting education on the nursing in oriental medicine. The oriental medicine is basically based on the principles that the most critical factor in promoting health and preventing disease is the process for improving the condition of both physical and mental part of patients. In this context it seems to be an valuable attempt to apply the principles of oriental medicine to the field of nursing care, and to develop the new methods. It is because promoting health, preventing disease, recovering health, alleviating pains are the basic responsibilities of nursing care. The national health policies have been increasingly emphasizing low-cost and high-efficiency just as in economic policies. In terms of cost-effectiveness nursing education in oriental medicine seems to be evaluated as good enough to satisfy these efficiency requirements. As a initial step for promoting and specializing the nursing education in oriental medicine it is absolutely needed to introduce and expand the curriculum on this new field. Increasing concerns about the oriental medicine as the third medical care is the world wide phenomenon now. Considering this trend, current insufficient curriculum on nursing in oriental medicine in education institutes, especially in four-year system nursing school, might be an undesirable phenomenon for future development of nursing education in Korea. In-depth studies about this issue are seriously needed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8993-9004
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• 2014

Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.

• The Journal of the Convergence on Culture Technology
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• v.10 no.1
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• pp.19-23
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• 2024

Patients with amputations of both hands need prosthetic hands that serve both cosmetic and functional purposes, and research on prosthetic hands using electromyography of remaining muscles is active, but there is still the problem of high cost. In this study, an artificial prosthetic hand was manufactured and its performance was evaluated using low-cost parts and software such as a surface electromyography sensor, machine learning software Edge Impulse, Arduino Nano 33 BLE, and 3D printing. Using signals acquired with surface electromyography sensors and subjected to digital signal processing through Edge Impulse, the flexing movement signals of each finger were transmitted to the fingers of the prosthetic hand model through training to determine the type of finger movement using machine learning. When the digital signal processing conditions were set to a notch filter of 60 Hz, a bandpass filter of 10-300 Hz, and a sampling frequency of 1,000 Hz, the accuracy of machine learning was the highest at 82.1%. The possibility of being confused between each finger flexion movement was highest for the ring finger, with a 44.7% chance of being confused with the movement of the index finger. More research is needed to successfully develop a low-cost prosthetic hand.

• Korean Journal of Clinical Pharmacy
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• v.13 no.2
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• pp.72-81
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• 2003

Adverse drug reaction (ADR) may increase hospital admission, morbidity and mortality and adding extra cost to healthcare expenditures. AIMS: This study was performed to identify the types of ADR being reported in a tertiary hospital, and to find out the ways to improve current ADR monitoring system. To investigate the attitudes of hospital pharmacists towards, and their understanding of ADR reporting. METHODS: Of 117 reports submitted to the pharmacy department during 3 months survey period, A questionnaire survey of 75 randomly selected hospital pharmacists was conducted. RESULT: Of the report was from patients aged between 60 and 70. The medical department with the high frequency in ADR reporting was Internal Medicines $(60\%)$. The most common ADR manifestations were gastrointestinal complaints $(47.8\%)\;and\;80\%$ of the reported cases were mild in their severity. The most common drugs suspected of causing ADR were CNS drugs which accounted for $38.4\%.\;55.5\%$ of respondent were aware of the need to education and information about ADR monitoring. The important reasons for unreporting ADR were unknown of how to report ADRs $(94.6\%)$. CONCLUSIONS: An ADR reporting system based on reporting by staff pharmacists has been effective increasing the number of reported reactions and pharmacist involvement in monitoring patients for ADRs. Pharmacists have the knowledge and responsibility to contribute to ADR reporting program. A great opportunity exists for pharmacists to contribute in this area of patient care.