• Research in Community and Public Health Nursing
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• v.27 no.3
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• pp.272-283
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• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• The Korean Journal of Health Service Management
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• v.12 no.1
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• pp.81-93
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• 2018

Objectives : This cross-sectional study aims to investigate the differences in general health status (GHS) and physical care burdens (PCB) of inpatient groups in long-term care hospitals (LTCH). Methods : The data of 228 patients were analyzed by integrating the electronic medical record (EMR) data of 2016, recorded by the nurses of hospitalized patients in the hospital. Results : There was a statistically significant difference in the GHS between the high-medical demand group and the other groups, but there was no difference in the GHS among other groups. The overall PCB was higher in the high-medical demand group than in the middle-medical demand, and cognitive impairment groups, but not in the problem behavioral group. Conclusions : The current classification of patient groups has shown limitations in terms of the basis of differential benefits of the groups. In particular, the PCB of the problem behavior group was not different from that of any group; hence, it should be adjusted through further study. To control the surge of medical care costs, it is necessary to improve the irrationality of the LTCH pay system in terms of the integration and continuity for elderly care.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.112-129
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• 1996

Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

• Korean Institute of Interior Design Journal
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• v.26 no.4
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• pp.22-29
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• 2017

This paper investigates the evaluation criteria in order to manage healing environment of long-term care elderly hospital. Elderly hospital evaluation tool developed by Korean Government is used to assess elderly hospital facilities to check the hospital facility and maintain its quality. However, the evaluation indicators and questions mainly focusing on safety indicators. Some questions are too vague for precise evaluation. In this paper, we discuss the advantages and disadvantages of the present evaluation criteria to establish new assessment tool for precise evaluation. The literature research was conducted tp set up the new evaluation criteria. From this research, we developed an elderly focusing on healing environment checklist for elderly care hospital which contains 7 factors as the primary hierarchy structure (Safety, Accessibility, Amenity, Sensibility, Friendly to nature, Territory, Interaction) and 23 factors as the secondary hierarchy structure. This evaluation criteria will help healthcare facility designers and healthcare organizations to build the healthcare facilities.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.2 no.1
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• pp.116-124
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• 1991

Nursing problems of 48 hospitalized patients with Conduct Disorder at a Child-Adolescent psychiatry inpatient were analyzed by reviewing nursing records. The results showed that the problems such as ineffective individual coping, impaired social interaction, disturbance in self-concept, potential for violence, alteration in parenting, altered growth and development were continued from early to later phase of the hospitalization and the other problems such as self-care deficit, anxiety, sleep disturbance, altered nutrition, hyperthermia were temporary. The etiologic factors related to these problems were underdeveloped ego, low self-esteem, dysfunctional parent-child relationship, some situational crises in family and handicap like mental retardation or epilepsy. Therefore nursing approach for the patients with Conduct Disorder should focus on ego growth and improvement of interpersonal relationship through systematic and long-term nursing plans and interventions for these patients and their family.