• 제목/요약/키워드: Hospitalization Program

검색결과 169건 처리시간 0.024초

노인 암환자의 건강보험과 의료급여 이용차이 분석 (Differences of Cancer Patient's Health Care Utilizations between Medical Aid Program and National Health Insurance in the Elderly)

  • 이용재
    • 한국콘텐츠학회논문지
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    • 제11권5호
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    • pp.270-279
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    • 2011
  • 본 연구는 건강보험심사청구자료에 대한 공변량분석과 다중회귀분석을 통해 노인 암환자의 건강보험과 의료급여 이용차이를 분석하고, 의료보장유형이 노인 암환자의 의료이용량에 미치는 영향을 분석함으로써 의료급여 환자의 도덕적 해이가 존재하는지 파악하는 데 목적이 있다. 연구결과, 첫째, 노인 의료급여 암환자가 건강보험 환자에 비해서 장기간 입원으로 총진료비를 많이 사용하고 있었다. 그러나 진료건당 외래진료비와 진료일당 입원진료비는 건강보험 암환자가 많아서 비용이 많이 소요되는 의료서비스를 더 많이 이용하고 있었다. 둘째, 노인 의료급여 암환자일수록 의료기관을 자주 외래방문하고 장기간 입원하여서 총진료비를 많이 사용하고 있었다. 그러나 진료건당 외래진료비와 진료일당 입원진료비는 건강보험 암환자일수록 증가하였다. 노인 의료급여 암환자들의 의료이용량 증가원인이 높은 비급여본인부담을 피해서 본인 부담이 없는 보험급여 의료서비스를 많이 이용 것에 있음을 알 수 있다.

슬관절 전치환술 환자의 조기퇴원 후 가정간호 운동 프로그램이 슬관절기능 상태와 삶의 질에 미치는 효과 (The Effects of Home Care Exercise Program on Knee Joint Function and Quality of Life in Patients with Total Knee Replacement Arthroplasty)

  • 이미경;이인희;주정혜;황문숙;서재곤;성영희
    • 근관절건강학회지
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    • 제12권2호
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    • pp.143-154
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    • 2005
  • Purpose: The aim of this study was to investigate the effects of home care exercise program on knee joint function(WOMAC) and the quality of life in patient with total knee replacement arthroplasty. Method: Forty-one subjects were sampled according to research criteria, and divided into two groups : 21 out of experimental group and 20 out of control group. The patients having treatment of total knee replacement arthroplasty were out of the hospital. After surgery executed, it took 8days for them to recovere their health conditions since 10th day, the experimental group received the home care exercise program per regularly four days interval. Results: 1) After applying home care exercise program, the total score on the WOMAC Index for the control group was $3.09{\pm}.76$. The score of the experimental group was $3.55{\pm}.55$ which is statistically higher than that of the control group. (P=.007). 2) After applying home care exercise program, the score of the quality of life for the control group was $3.09{\pm}.50$. The score of the experimental group was $3.46{\pm}.35$ Which is statistically higher than that of the control group. (P=.007). Conclusion: This figures show that home care exercise program has good results. These findings also indicate that the services of home care exercise program are alternatives for the hospitalization.

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신생아 중환자실에 입원한 환아 어머니의 스트레스 (A Study on the Perceived Stress of Mothers in Neonatal Intensive Care Unit)

  • 최성희
    • Child Health Nursing Research
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    • 제4권1호
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    • pp.60-75
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    • 1998
  • The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.

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심장재활 교육프로그램이 심근 경색증 환자의 질병관련 지식과 건강행위 이행에 미치는 효과 (Effects of Cardiac Rehabilitation Teaching Program on Knowledge Level and Compliance of Health Behavior for Patients with Myocardial Infarction)

  • 정혜선;김희승;유양숙;문정순
    • 대한간호학회지
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    • 제32권1호
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    • pp.50-61
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    • 2002
  • The purpose of this study was to investigate the effects of cardiac rehabilitation teaching program on knowledge level and compliance of health behavior for the patients with myocardial infarction. Method: The subjects were 47 patients 23 were assigned to the experimental group and 24 were for the control. The cardiac rehabilitation teaching program is a individualized teaching program which was delivered to the experimental group during hospitalization period by present researcher. Data were collected through questionnaire surveys for knowledge level and compliance of health behavior from September 15, 1999 to December 31, 2000. The collected data was analyzed by using the SAS program. Results: 1. With regard to the knowledge scores 1) The total knowledge level in the experimental group was significantly higher than in the control group. 2) As to the knowledge domains, nature of disease, risk factors, diet, medication, exercise, and daily activities were significantly higher in score in the experimental group than in the control group. 2. With regard to the compliance of health behavior 1) The average compliance with good health behavior was significantly higher in the experimental group than in the control group. 2) As to the health behavior domains smoking cessation, diet, stress management, regular exercise, and other measures for lifestyle modification were significantly higher in score in the experimental group than in the control group. 3. The pre-treatment knowledge score was positively correlated to the post-treatment knowledge score and post- treatment knowledge score was positively correlated to the post-treatment compliance of health behaviors. Conclusion: The above findings indicate that the cardiac rehabilitation teaching program for the experimental group was effective in increasing level of knowledge and improvement of compliance with good health behavior of patients with myocardial infarction.

저강도 운동프로그램이 입원노인의 일상활동 기능회복에 미치는 영향 (Effects of Low-intensity Exercise on Functional Ability in Hospitalized Elderly)

  • 송라윤;서연옥;엄영란;전경자
    • 대한간호학회지
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    • 제27권4호
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    • pp.807-819
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    • 1997
  • The purpose of the study was to identify the effects of a 12-week low-intensity exercise program on muscle strength, flexibility, balance, and cognitive characteristics related to the performance of activity of daily living(ADL). A total of 16 patients who were admitted to the medical unit of a general hospital in ChoongChung province were recruited, eight for the exercise group and eight for the comparison group. Four levels of low-intensity exercise from 'ROM on bed' to 'exercise while walking' were then applied to the exercise group according to their physical condition. During hospitalization, patients in the exercise group performed each level of the prescribed exercise with the researchers until they felt comfortable doing it independently. The researchers also visited the patients' homes after discharge to make sure they could perform the exercise with Theraband in their living environment. The exercise group was contacted by phone once a week to assess the frequency and intensity in which they performed the exercise as well as their physical condition. The subjects in the comparison group participated in measurements for the study without performing the exercise and were contacted by phone after discharge, in a matched time frame with the exercise group, to assess physical condition. Muscle strength, flexibility, balance, cognitive characteristics, and performance of ADL for the two groups were compared at the pretest and the posttest after the low-intensity exercise program by utilizing SPSSWIN and the results are as follows : 1) At the postest, measurements of muscle strengths showed that the strength of the dorsal flexor in the exercise group was significantly higher than in the comparison group. 2) Objective balance for the exercise group was significantly better than for the comparison group as measured by 'standing on one foot' and Tinetti gait and balance control. 3) The exercise group showed significantly higher task self-efficacy than the comparison group. 4) Perceived exertion for ADL for the exercise group was significantly lower than for the comparison group. 5) Improvement of performance of ADL without assistance was significantly higher for the exercise group than the comparison group. The findings suggest that a low-intensity exercise program would be useful for the elderly who show decline in their physical functioning due to hospitalization by partly improving physical strength, task self-efficacy, and performance of ADL. Directions for further research on issues of motivating people to exercise as well as of standardizing various types of exercise were discussed.

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개심술을 받은 심기형 환아모의 교육프로그램 개발을 위한 조사연구 (Descriptive Study on the Development of Educational Program for Mothers with Children who have had Open Heart Surgery in Congenital Heart Disease)

  • 이군자;조현숙
    • 재활간호학회지
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    • 제4권1호
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    • pp.73-83
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    • 2001
  • The aims of this study were to identify the mothers educational needs when they have children who have had open heart surgery in congenital heart disease, to identify the children's characteristics with this problem, and also to provide the basic information on the development of the educational program for the mothers. The subjects of the study were 101 mothers of children and their children hospitalized with congenital heart disease in pediatric wards of G. University Hospital in Inchon and S. Hospital in Puch on from June to November 2000. The study used a Likert-type questionnaire with 39 questions which was based on a previous questionnaire developed by Lee Mi-ryun(1989) for adult open heart surgery patients. The reliability of the questionnaire was Cronbach' ${\alpha}$=.9375. The data were collected directly from mothers of the patients in wards. The t-test, ANOVA was adopted for the data analysis. The key results of the study are as follows : 1) The average age of the children was 32.90 months. The majority of the children are male and weighted 3.0-3.5Kg at birth. Most of the children had VSD(29.7%), and 10.9% of children had a family history of heart disease. 2) An average score of 4.62 out of a maximum of 5.00 was recorded for the educational needs of the children's mother. The highest score of 4.69 was for home care after discharge followed by a score of 4.67 for diagnosis and prognosis on congenital heart disease. And pre-post operation care scored 4.51. The mean scores of single-question items of educational need were, in order, 4.81 for immunization after operation, 4.80 for recovery process, and 4.77 for prognosis of the disease. The score of 4.18 for measurement of intake and output was the lowest. 3) The analysis on the children's mothers educational needs by social-demographic characteristics such as sex, age of patient and mother, economical status, educational status, number of child, hospitalization times, and hospitalization cause showed no significant difference statistically, but there was a significant difference between mothers with jobs and with out jobs.

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醫療保險 財政共同事業의 效果分析 (An Analysis on the Effect of Financial Stabilization Program in the Korean Health Insurance)

  • 이현실;남길현
    • 보건행정학회지
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    • 제7권1호
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    • pp.73-99
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    • 1997
  • This study was carried out by using questionnaires with 126 insurance societies from Sept. 30, 1995 to Oct. 18, 1995. The primary data collected bythe survey have been significantly supplemented by secondary data obtained from sources such as health insurance statistical year books and internal data in the Ministry of Health and Wolfare. Major findings were summarized as follows: Two financial coordinating programs have significantly improved financial status of regional health insurance societies: the catastrophic program for high cost medical care that was initiated in 1991 and the program for hospitalization cost of the aged in 1995. Another finding is that there existed ambiguity and inconsistency of equity index that had been used by stabilization programs and its side effects could not be ignored. Regression analyses were made to identify factors that affect financial transfers. Inde pendent variables in the regression include utilization frequency, dependancy ration, insurance contribution per insured and medical expense per insured. All these variables were statistically significant in the equations of applying distribution rate (distribution/contribution) and transfer rate (transfer/contribution) as dependent variables. Policy suggestions for the catastrophic program for high cost medical care are modifying the definition of catastrophic case and setting the maximum amount of subsidies for each society based on distribution rates. To solve the problems of the financial coordinating program for the aged, we could consider reimbursing more than 50% of the copayment incurred by the aged 65 or more and determining the maximum amount of outpatient copayment at 10,000 Won per day or per visit for the elderly. More fundamental improvement could be made by amending the Welfare Benefit Act to establish and expand medical and welfare facilities for the elderly.

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뇌혈관질환자의 구강건강관리프로그램 효과 (The effect of oral hygiene care program in stroke patients)

  • 동판;이윤희;이희경
    • 한국치위생학회지
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    • 제14권3호
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    • pp.363-370
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    • 2014
  • Objectives : The purpose of the study is to investigate the effect of the oral hygiene care program in stroke patients. Methods : The subjects were 62 stroke patients of rehabilitation department in Youngnam University Hospital in Daegu. The study was carried out from January, 2010 to October, 2010. Intervention group was 35 and the control group was 31 patients. Tooth brushing instruction, oral health education and scaling were implemented in all patients at baseline. This program was conducted 5 times during hospitalization in intervention group. Results : In the intervention group, the mean age was 59.2 years, and women accounted for 66.7% and the control group consisted of 72.4% of women and mean age was 58.5 years. The average of the number of permanent teeth with experience of dental caries, the values of dental calculus index, plaque index, bleeding index and tooth mobility were 11.88, 11.79, 9.91, 3.16 and 1.16, respectively. The control group showed 10.21, 11.79, 9.91, 3.16 and 1.16, respectively. The proportion of subjects whose CPI was higher than 3 accounted for 97%, and the O'Leary index score was 38.6 in the intervention grou. The control group showed 100% and 38.79. Conclusions : Oral condition improved significantly in the intervention group in the third session. These findings may provide essential information for oral health program planning and implementation.

고관절 수술환자에게 적용한 섬망 예방프로그램의 효과 (Effects of Delirium Prevention Program in Patients after Hip Joint Surgery)

  • 사공은미;김숙영
    • 한국콘텐츠학회논문지
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    • 제18권10호
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    • pp.134-144
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    • 2018
  • 본 연구는 고관절 수술 환자에게 섬망 예방프로그램을 적용하여 그 효과를 검증하기 위한 비동등성 대조군 사후설계를 이용한 유사실험연구이다. 연구대상은 일 종합병원에서 고관절 수술후 외과계중환자실에 입실한 65세 이상 노인 환자였으며 실험군 33명, 대조군 31명이었다. 실험군에게 섬망 예방프로그램을 적용하였으며 구체적 내용은 오리엔테이션 중재, 활동 중재, 생리적 중재, 영양 중재, 수면 중재, 환경 중재로 구성되었다. 자료분석은 ${\chi}^2-test$, independent t-test로 분석하였다. 연구결과 실험군은 대조군 보다 섬망 발생률이 낮은 것으로 나타났다(${\chi}^2=7.048$, p=.008). 실험군은 대조군 보다 중환자실 재실일수와 재원일수가 적었으나 통계적으로 유의하지 않은 것으로 나타났다. 본 연구에서 적용한 섬망 예방프로그램은 고관절 수술환자의 섬망을 예방하는데 효과적임을 확인하였으며 향후 고관절 수술환자 섬망 예방을 위해 실무에 적용할 수 있을 것으로 기대한다.

4년제 정규과정과 RN-BSN과정 간호학생의 간호관 비교 (Comparing Nursing Perspective Between BSN and RN-BSN Program Student)

  • 백승남;조결자
    • 간호행정학회지
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    • 제10권4호
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    • pp.417-425
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    • 2004
  • This descriptive survey design study was aimed to investigate nursing students' perspectives of nursing care. One hundred seventeen junior or senior students in BSN program and 131 junior or senior students in RN-BSN program at K University were compared and contrasted in terms of their perspectives on nursing care. Using the instrument developed by Cho Kyoul-Ja and Song Mi-Ryung(1997), the data were collected from April 1st to April 30th in 2003. The findings of the research are as follows. 1. The average perspective score of the RN-BSN students was higher than that of the BSN students. 2. The RN-BSN students reported higher scores than those of the BSN students in perspectives on personal qualification and meanings, and perspectives on scope and function of their nursing care. However, there was no significant difference between the groups in overall nature and domains of nursing care. 3. In terms of the participants' demographic backgrounds such as, grades in the program, religion, history of hospitalization, there was no significant difference between the BSN and RN-BSN groups. 4. No significant difference was found within the RN-BSN group in terms of their nursing perspectives associated with the years of clinical experience. In conclusion, the score of nursing perspectives in RN-BSN student group was higher than that of the BSN students. No other differences were found in this study. The higher nursing perspective score in RN-BSN group is attributed to their clinical experience. Thus, it is suggested that philosophy and value of nursing should be taught early in nursing program in order for nursing students to obtain proper points of views on nursing care. In addition, nursing philosophy, holistic view, and humanistic values should be stressed in continuing education for clinical nurses in order for them to maintain dignitary perspectives in nursing care.

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